Posts Tagged ‘PHRs’

Predicting Health IT Five Years Out

August 30, 2010

In an article in xConomy Seattle, there is a report from a meeting of the Washington Biotechnology and Biomedical Association, reporting on the future of Health IT. Some key predictions:

  • “As we near 2015, many in the industry predict healthcare will see an integration of social media, cloud computing, and collaborative commons—creating resources that allow consumers to more actively engage with their health through information technology.”
  • “primary care facilities and hospitals are not capitalizing on the existence of electronic resources to provide better care for patients and improve efficiency for healthcare providers”
  • “Healthcare is the last bastion of mom and pop stores,” ?The first step in healthcare is to make everything digital,”  “The next step is to takes what’s digital, and make sense of it—to make some intelligence out of the information you already have.”
  • “Arguably healthcare is a data problem, and we’re trying “Scientists are not thinking of their data as an ingredient to the solution. They’re thinking of it as an ingredient to their next paper,”
  • “researchers will have to amend not only what they do, but how they go about doing it—the emphasis will become less about research and clinical data, and more about how that data is stored, accessed, and used”
  • “models could also use the power of social networks to give patients access to information and resources provided by other patients with similar conditionals—data that could help patients research and decide on a treatment plan, as well as help physicians make recommendations.”
  • “One example would be using personalized data from electronic medical records, combined with data from available studies, to create individualized predictive care models.”

All great ideas held back by cottage industry attitudes and slow adoption of EHRs and PHRs. My only question is, why can’t we have this sooner than 5 years?

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Open Notes Project – Right Thing or Wrong Question

August 18, 2010

The discussion of having doctors notes on one’s care readily available electronically was stimulated by a recent New York Times article titled, Should Patients Read the Doctor’s Notes? Roni Zeiger of Google Health challenges whether this is the right question.  For  e-Patients, it is both the wrong question or obviously the right thing to do. Transparency of medical records, now written into health care reform, is the obvious right thing to do but will take time for physicians to catch up to the idea. Granted that few patients even have access to a PHR tethered to and EMR, but at least those that do should have access to notes in the long run. If patients are to be full participants in their health care and treatment, they should know their doctors observations and treatment plans. As Roni Zeiger says this is one of  “the best ways for the patient to understand and remember the doctor’s guidance.”

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What’s New with PHRs – evidence and interoperability

July 16, 2010

A new study from Kaiser documents some clear clinical benefits for the use of PHRs.  The study, which was published in the July issue of Health Affairs, observed 35,423 patients with diabetes, hypertension, or both. Researchers found that the use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements. Results included 2 to 6.5 percentage point improvements in glycemic, cholesterol and blood pressure screening and control.

Also, there is a good video on PHR/eHealth application interoperability which also promotes the Health 2.0 Accelerator. The future of patient centric care must be interoperable. Watch the video.

Part of the video is a demo of  SurveyorHealth for managing medications which includes an interesting tool Simulate Alternatives. Check out one of the demo patients.

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The Quantified Self in Healthcare – Part 2

May 10, 2010

More evidence of this movement continues to emerge. For instance, I came across the Philips DirectLife device today which can record a number of activity parameters to quantify one’s life. In an article in the Linux Journal, of all places, there is an article title, Now Data Gets. Personal. The author cites Alexandra Carmichael of CureTogether and the Quantified Self Community as a prime example. The article points back to an earlier one in the same journal called The Patient as the Platform. The author proposes that through the use of PHRs controlled by patients, such as, Google Health, the patient could be center of health information rather than the provider or payer. This article from 2008 essentially proposes a solution for health information exchange without costly state or national initiatives.

The combination of the quantified self and the patient as the platform can potentially create a future where rich information is controlled by the patient and shared with providers to enhance personal wellness and treat conditions. Adding social networking with like patients creates a powerful trio of technology for the e-patient.

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New PHR Report from California Healthcare Foundation

April 13, 2010

Titled “Consumers and Health Information Technology: A National Survey“, the survey shows some promising progress:

  • users cite taking steps to improve their own health, knowing more about their health care, and asking their doctors questions
  • lower-income adults, those with chronic conditions, and those without a college degree are more likely to experience positive effects of having their information accessible online
  • Two-thirds remain concerned about the privacy and security
  • should not let privacy concerns stop us from learning how health IT can improve health care
  • almost half are interested in medical devices that can be connected to the Internet.
  • Of those who do not have a PHR, 40% express interest in using one.

Also just released is a major report from Price Waterhouse Coopers, The customization of diagnosis, care and cure. A key part of this report is patient touchpoints inlcuding:

  • coordinated care teams
  • fluent navigators
  • patient experience benchmarks
  • medical proving grounds
  • care anywhere networks (aka, mHealth).

The common theme here is participatory medicine, which as it turns out, appeared in a post by Roni Zeiger of Google Health in Huffinton Post. His key quote is, “Data on its own is useless. It’s all about conversations.” Health data whether in personal health records or social networking sites or other tools is essential in creating a conversation about how to improve and maintain health.

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PHRs, EHRs and Social Media – Where are We Headed?

February 2, 2010

Two coincidental articles were published today. First, in iHealthBeat, John Moore and Matthew Holt talk about why “Consumers Not Ready for Do-It-Yourself PHRs.” In response to the decision by Revolution Health to discontinue their PHR, the experts comment that “the direct-to-consumer market for PHRs just doesn’t work.” But they say that populated records are the future, those tethered to EHRs, like Kaiser’s and how Google Health and Microsoft HealthVault enable this kind of population of data from other sources. In the future, as it is now for some, the PHR will not be separate from the EHR, just the interface on the front of patient data. But this will mean patient entered data, like diaries of their conditions, and from home monitoring devices.

The second article appeared in JAMA, from the Centre for eHealth Innovation in Toronto, titled, “Electronic Health Records in the Age of Social Networks and Global Telecommunications.” Here the authors talk about the intersection of social media and EHRs. Specifically, the authors envision the future with open standards which can enhance interoperability and “natural language enrich by audio or video…Rich media has the potential to reduce ambiguity and enhance performance in complex tasks.”

So while the concept of PHRs may be on the decline, the future of patient empowerment through information has only begun. The convergence of personal health information, provider-based information and social and rich media will provide a basis for future health decisions on a very individual, personal level.

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Major Robert Wood Johnson Foundation Report on PHRs

January 19, 2010

The Robert Wood Johnson Foundation has published an 7 chapter online book about Personal Health Records. The book is a great summary of the current state of PHRs as well as initiatives promoted by Project Health Design. Chapters are:

Chapter 1: Personal Health Records 101
Chapter 2: Project HealthDesign and the Next Generation of Personal Health Records
Chapter 3: Observations of Daily Living
Chapter 4: The Health Information Technology Landscape
Chapter 5: Personal Health Records and Health Information Technology—Costs, Policies and the Incentives Driving Adoption
Chapter 6: Privacy and Personal Health Records
Chapter 7: Personal Health Records—Business Models, Open Platforms and the Challenges Ahead

Worthy of note is chapter 3 on Observations of Daily Living (ODL), the importance of having patients enter their own daily activities and disease experience into a PHR. While the chapter does not specifically mention social networking sites like Organized Wisdom or PatientsLikeMe, the implication is that these type of tools provide value, often unrealized, by most provider organizations. ODLs could also include direct input into a tethered PHR or via home monitoring devices.

Also presented well is the discussion of the Health IT landscape and the emphasis on open platforms. Microsoft HealthVault and Google Health are described as revolutionary innovations. They provide PHRs with open connections to EHRs and devices as well as a portable, web-based record empowering patients to bring their records to any provider.

They conclude with addressing business models and incentives to make PHRs successful. “Open platforms create a wide avenue for innovation in health care” and the need to move past proprietary models is promoted. I might add that existing proprietary EMRs must be able to talk to the open platforms through web services or the CCR standard. There is no excuse for not adapting to these standards to enable the transfer of data into patients’ control.

Looking toward future and the new grant recipients for Project Health Design, the authors conclude: “They will face a number of challenges, including how to capture observations of daily living (ODLs); how to aggregate and analyze those data in a PHR; how to use the findings to inform the clinical encounter; and, ultimately, how to empower patients to understand, influence and improve their health. “

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Mayo Clinic Launches Health Manager using HealthVault

April 22, 2009

Mayo Clinic has announced its new Personal Health Record called Health Manager. Besides a feature rich tool including managing personal health information, monitoring health using a dashboard feature and getting health advice (integration with their health content), there are some significant aspects of this announcement:

  • partnership with Microsoft HealthVault - right behind New York Presbyterian. The first two large medical centers to announce their Microsoft partnership
  • this occurred right  after the announcement of stricter HIPAA rules under the HITECH federal regulations
  • It is offered to the general public and not just patients of Mayo Clinic. MyNYP approaches this in the same way. It focuses it health information on heart health with an intro by Mehmet Oz of the You books fame.

The strategy appears to be to offer a service and potential attract new patients. The extent of the integration strategy with Microsoft HealthVault is unclear – can one create an account at one of these sites but then login directly through HealthVault? These two new sites will be interesting to watch.

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Interoperability and PHRs

March 23, 2009

On John Halamka’s CIO blog, he does a good job of introducing the basics of the Healthcare IT alphabet soup and then some. Specifically, he addresses his opinions on:

  • interoperability: “meaningful use will include: Problems lists/Diagnoses, Medications including e-prescribing, Allergies, Text-based summaries, Quality data sets, Population health data sets submitted to CDC, public health departments, and other government agencies.”
  • PHRs and Smart Cards: “Smart cards have not received wide acceptance in any US industry, although they are very popular in other parts of the world….I believe it is much more likely that web-based Personal Health
    Records, such as those provided by Google, Microsoft, and Dossia, will
    be more popular than smart cards. These PHRs are secure, protect
    confidentiality, and are automatically updated by labs, pharmacies,
    hospitals, and clinician offices.”

Smart cards were recently endorsed byt the Committee on Operating Rules for Information Exchange.
I agree with Halamka on this – I think PHRs such as Google Health have a better chance of adoption in the US.

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HIMSS eHealth SIG to present on PHRs

February 11, 2009

The Webex will occur on Wednesday, February 18, 2009 at 3pm EST.  They made a good choice of presenters:

  • Wes Rishel, VP and Distinguished Analyst, Gartner, Inc.
  • Matt Guldin, Product Manager, HealthNet, former Industry Analyst with Frost & Sullivan

I’ve known Matt for some time now – he brings a broad perspective on this and, of course, Gartner always has its hands on the pulse of things.

If you are interested in attending, contact Ben Dillion at ben.dillon@geonetric.com.

The HIMSS eHealth Special Interest Group will also meet in person at the Annual HIMSS conference in Chicago. The meeting will be  Monday, April 6, 2009 from 1:00 – 2:30pm at the Hyatt Conference Center in room 12AB. The topic is “Health 2.0.” Watch this blog for more info. I will be there.

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