18 pages-Single-spaced-Class Journal

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IS531_Lecture-6.ppt

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Lecture 6

Personal Health Record

(Chapter 16)

Learning Objectives

Personal Health record (PHR) vs. Electronic Health Record (EHR)

Stand-alone, tethered, and networked PHRs.

Common functionality available in the PHR – Benefits and concerns

Impacts of PHRs

Issues in implementation and adoption

IS 531 : Lecture 6

Personal Health Records

A private, secure application (different from an EHR)

Data from an EHR or providers accessible to patients, 24/7 from home

Information from multiple sources entered by the patient

Driven by patients: access, provide, manage, share personal health info

IS 531 : Lecture 6

Personal Health Records

IS 531 : Lecture 6

PHRs

Precursors to Electronic PHRs: notebooks, files, written records.

Standalone systems: not tied to any healthcare system.
Google Health PHR, Microsoft’s Health Vault
Tethered systems: tied into a healthcare system.
My HealtheVet PHR from the VA
Networked systems : access data from multiple locations

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Attributes of an ideal PHR

IS 531 : Lecture 6

Personal Health Records

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PHR Functions . . .

EHR personal heath information

Lab and test results
Medication lists
Appointment
After-visit summaries
Clinical notes
Patient clinical reminders

IS 531 : Lecture 6

. . .PHR Functions

Secure messaging

Self-entered data

Proxy use (delegation)

Administrative and finance

IS 531 : Lecture 6

EHR Personal Health Information

Lab and test results

Medication lists

Appointments

After-visit summaries

Clinical notes

Patient clinical reminders

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Lab and Test results

Display test names, test values, normal ranges (may have some extra info: what for, why, what next)

Benefits:

Reduce patient waiting time
Avoid letters and phone calls

Concerns:

May confuse and worry patients
Display non-sensitive results only

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Lab and Test results

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Medication Management

List past and current prescribed medications (doses, instructions, allergies)

Benefits:

Can check prescriptions for administering
Discussion with physician for clarification
Share info with other providers

Concerns:

Inaccurate and incomplete if medications are from multiple providers

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Appointment Management

Time, date, location for scheduled visits, tests, procedures.

Can request appointments (subjected to provider confirmations)

Benefits:

Keep track upcoming care: reduce missed /cancelled appointments
Patient convenient, less phone scheduling

Concerns:

Institutions can not control open access
Self-selected appointments not match with level/type of care needed

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After-visit Summary

What, advice, vital signs, prescriptions

Benefits:

Help patients recall the discussion during clinical encounter
Reinforce clinical advices
Can share info with caregivers

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Clinical Notes

The actual physician write-up of the visit

Benefits:

Better understand clinician assessments and decisions
Better understand clinician issues and treatment options

Concerns:

Terminologies may confuse patients
Clinicians resist sharing notes or even alter them

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Clinical Reminders

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Notices on recommended screening and preventive cares

Benefit:

Increase patients adherence to preventive care

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Secure Messaging

Confidential and secure online communication between patients and their providers

Benefits:

Convenient 24/7 access
Can include available medical record

Concerns:

Fitting in professionals’ workflow: time, responsibility
Reimbursement for time in online service
Patient may unintentional misuse

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Self-Entered Data

May include prior medical history, family history, alternative medications, self-recorded vitals

Benefits

Important data complementary to EHR
Patient can see the trends needing attention

Concerns:

What type of data to enter
Clinical responsibility to view and response to information

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Proxy Users

Permit other persons (parent, caregivers) access to patient PHR (may have different levels of access)

Benefit:

Sharing information and care with givers

Concern:

Release information intended to be private

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Administration and Finance

Ability to view bills, copayments, coverage benefits (may take online payments)

Benefits

Help manage care and finances
Improve knowledge of benefits

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Issues Related to PHRs

Delegation of access to PHR via a proxy user

Access to financial, medical claims

Privacy (who accessing what)

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Impacts of PHR

Patient satisfaction (timely interaction with providers, 24/7 from home)

Provider satisfaction (conflicting perceptions)

Quality of care (subjected to digital divided)

“Participatory Medicine”: patients are responsible for their health

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Issues

Effective utilization from users increase the efficiency of the systems

Change in clinical works: process, responsibility, time

Handle patient data: what data, what format, who is responsible for viewing/ answering

Provider resources and liability

Consumer protection of privacy

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PHR Adoption

Access: connect to Internet by users

Awareness: knowledge about the PHR tools and their values

Usability: easy-of-use

eHealth literacy: computer literacy (how), effective usage of the system (what for)

Meaningful use: favorable user perception

Clinical integration: PHR should be considered as a source of information for healthcare professionals

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A PHR Sample

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http://www.myphr.com/Default.aspx

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Closing Notes

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Under the EHR Incentive Program, participating providers are required to provide individuals with access to certain information on much faster timeframes (e.g., a discharge summary within 36 hours of discharge, a lab result within 4 business days after the provider has received the results)

(https://www.hhs.gov/hipaa/for-professionals/faq/2051/under-the-ehr-incentive-program-participating-providers/index.html)

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Closing Notes

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“Most patients should have access to EHR by 2014 (Executive Order 13335, 2004)”

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