Aetna Clients to Get Access to Online Health Data

Computerworld -

Aetna Inc. is weeks away from launching an application that will provide its 15 million customers with online access to their health care information. The launch will culminate a two-year internal development effort by the Hartford, Conn.-based insurer.

Access to the online Aetna CareEngine-powered Personal Health Record (PHR) software will be available to 1 million clients by the end of March and to the remaining 14 million customers during the second quarter, Aetna officials said.

The system lets Aetna clients access health data compiled from insurance claims and other external sources, and it allows the customers to update their own records with data such as blood pressure readings taken at home.

An analytic engine developed by New York-based Aetna subsidiary ActiveHealth Management Inc. will analyze the PHRs daily and notify patients if their care falls out of line with commonly accepted best practices, said Robert Heyl, architect manager of Aetna’s E-Health business unit.

For example, Heyl said, the CareEngine software can determine whether a physician has prescribed medication that could have an adverse reaction with medicine prescribed by another doctor. The system can notify affected clients of such potential problems by telephone and e-mail.

Insurance providers and employers are adopting electronic health records in an effort to reduce duplicate testing, medical errors and other problems. The records allow consumers to share comprehensive data with health care providers rather than depend on fragmented data maintained by multiple physicians and hospitals.

Standards Support

Aetna was among more than 1,000 insurance companies, with a total of 200 million customers, that last month announced support for standards for creating and managing electronic health records.

The Aetna claims data will be fed to the CareEngine analytic software through Web services messages, Heyl said. The ActiveHealth engine will compare that data to a large set of rules developed by physicians for 30 different medical conditions, he added.

“[The CareEngine] will look at individual records for evidence across multiple data points to allow it to create a statistically valid conclusion,” Heyl said. “Whatever conclusions are made, whatever your health status is, [it] gets summarized into a PHR.”

Customers will access the online records by using an Aetna-built Microsoft .Net-based application that uses Web services to transmit information between the online interface and ActiveHealth’s databases, Heyl said.

The PHR data will be stored on a Microsoft SQL Server database, and ActiveHealth is using an Oracle Corp. database to add advanced analytics capabilities, he said.

The application also includes a link to some of Aetna’s internal Java applications, such as call center and disease management software, that use IBM’s WebSphere middleware.

“We’ve placed an intermediary between the Java and .Net interactions that works on XML to make sure ... we remove any kind of .Net-skewed XML data types or Java-skewed data types,” Heyl said.

Aetna considered using an enterprise service bus to provide interoperability between the .Net and Java software but instead opted to write custom code because of concerns that an ESB might not provide the needed scalability, he said.

The biggest challenge was to find a way to manage and authenticate patient identities, Heyl said. The insurer is using the OASIS WS-Security standards that are related to federated identity management. It’s also using IBM’s Tivoli access management software and Microsoft Corp.’s Active Directory for identity management.

Liz Boehm, an analyst at Forrester Research Inc., said that while other insurance companies have offered PHRs regionally, Aetna may be one of the first to offer them nationally. The company, she noted, likely will have to offer incentives, such as discounts on premiums, to foster adoption of the online system to help overcome patient fears about security and privacy.

Source: Forrester Research Inc., June 2006

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