The Ideal Personal Health Record Michael R. Fisher Senior Web Developer Scott A. Smiley Web Developer
Who We Are Community Health Network is a hospital network located in Indianapolis, Indiana consists of five hospitals surgery centers physician practices urgent care clinics home care etc. http://www.ecommunity.com/
Some Definitions Personal Health Record (PHR) - The record(s) that a patient keeps about themselves or a family member. The sole authority on what is put in a patient's PHR is determined by the patient or family member.
Some Definitions Electronic Medical Record (EMR) - The record(s) that the health care provider (hospital, doctor, nurse, etc) keep about a patient. The authority on what is put in a patient's EMR is determined by the health care professional.
Some Statistics Harris interactive online poll of more than 2000 U.S. adults reported that 42% of the respondents kept some type of PHR, of those 86% did so on paper Seen in statistics from many sources of 1-10% of online users keep a PHR, most of the numbers are at about 4% 80% of American Internet users go online to look for health care information (PEW Internet Study American Life Project October 2006)
Best Practices
Accessible, Private and Secure Accessible whenever and wherever needed HIPAA Strong security
Patient Controlled Patient controls what data is put into their PHR Share data in their personal health record to whomever they feel is appropriate Controlled at the level of each individual entry
Access Patient s EMR Interact with a patient s electronic medical record. Information should flow to the PHR from the EMR Send data to the EMR (which can be accepted or rejected by the physician as needed). Would increase patient adoption Quicken, Money
Transparent Audit trail available to user Data items came from that are in their personal health record Who entered it Who has viewed each item and when
Secure Patient-Provider Communication Communicate with their physician(s) Ask questions Report health measurements evisits
Capture Self-Reported Values Allow a patient to enter their own information Missing or incomplete data
Provide Patient Education Provide education Conditions Surgeries Medications etc. A better informed patient is a better patient
Provide Health Management Tools Data tracking tools, data management tools Compare data to what it should be so to improve health Weight tracking Blood sugar, blood pressure, cholesterol Fitness tracking
Interoperability Information needs to be in a format that can be exported or shared Other personal health records Electronic medical records (EMRs) Some standards include HL7 CCR CCD
Lifelong and Comprehensive Entire health history of a patient Include all health care providers the patient has seen
Demonstration
Putting the PHR Puzzle Together NDC Personalized to the Patient CHNw Medication, actions, side effects, drug interactions APIs NDC # CHNw Library Medications Actions Side Effects Interactions Community Physicians of Indiana Centricity EMR Electronic Medical Record
Clinician Receives Renewal Request
Clinician Receives Secure Message
Putting the PHR Puzzle Together DRG & IC9 Patient CHNwspecific Conditions, Procedures, Tests APIs DRG# ICD9# CHNw Library Conditions Procedures Tests Community Physicians of Indiana Centricity EMR Electronic Medical Record
Images page
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mycommunity Experience Virtual PHR: available any where patient has access to Internet browser Centralized access source of registration information for patient and staff
Mobile
Statistics of Our Usage Approximately 35,000 mycommunity Members Over 1700 current PHR users 06% (six percent) utilization of mycommunity PHR In production since July 2006
PHR Strategies: Data Quality Government VA using data to reduce health care expenses Latency of data to update would be an issue Focus not on user experience if government is involved Would users trust the government with private medical data? Vendor (Google, Microsoft, etc.) Not bound by HIPAA regulations of data storage, security, data access requirements and who can view the data Not linked to a health care organization Would users trust vendors with private medical data?
PHR Strategies: Data Quality Cont. Insurance Company Uses claims data to reduce health care expenses Data not available immediately after seeing health care provider Data is about what is coded, not necessarily what was diagnosed Would users trust insurance company with private medical data? RHIO (Regional Health Information Organization) Latency of data to update would be an issue Data would need to be scrubbed coming from different health care systems Relies on competing systems to cooperate
PHR Strategies: Data Quality Cont. Health Care Organization Better patient care which should reduce costs Data is accessed the quickest Linked to provide so that the patient can make changes and ask questions based on current health state Fewer health care systems involved to integrate data Patient trusts them with their care
Michael R. Fisher, M.I.S. Senior Web Developer mrfisher@ecommunity.com blogs.ecommunity.com/blog/fiveyearsfromnow 317.621.7075 Scott Smiley Web Developer ssmiley@ecommunity.com 317.621.7085
Source citations Claudia Pagliari, Don Detmer and Peter Singleton, Potential of electronic personal health records, BMJ/August 18, 2007/Volume 335 William R. Kupchunas, Personal Health Record, Orthopaedic Nursing May/June 2007/Volume 26/Number 3 Paul C. Tang and David Lansky, From the Field The Missing Link: Bridging the Patient-Provider Health Information Gap, Health Affairs September/October 2005/Volume 24/Number 5 Paul C. Tang, MD, Carol Newcomb, MHSA, Informing Patients: A guide for Providing Patient Health Information, Journal of the American Medical Informatics Association November/December 1998/Volume 5/Number 6 The Common Framework: Overview and Principles, http://connectingforhealth.org/commonframework/docs/overview.pdf
More Information: EMR http://en.wikipedia.org/wiki/electronic_medical_record http://en.wikipedia.org/wiki/electronic_health_record http://www.providersedge.com/ http://www.himss.org/asp/topics_ehr.asp
More Information: PHR http://en.wikipedia.org/wiki/personal_health_record http://www.myphr.com/ http://www.connectingforhealth.org/ http://www.nlm.nih.gov/medlineplus/personalmedicalrecords. html http://www.himss.org/content/files/phrdefinition071707.pdf http://www.himss.org/content/files/ephr_checklist.pdf