Download Personal Health Records

VERMONT INFORMATION TECHNOLOGY
LEADERS
Vermont Health Information
Technology Plan (VHITP)
Educational Presentation
Personal Health Records (PHR) Overview / Strategies
VITL Board Meeting
May 23, 2007
1
Agenda
• Personal Health Records
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–
–
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What are they?
Why are we talking about them now?
What are the types of PHRs?
How do they affect patients? Practitioners? VITL?
• Implementation Strategy
– PHRs in the context of thinking about HIEN strategy
– Implementation strategy in the VHITP
– A three-step process
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Personal Health
Record (PHR)
• The idea behind the personal health record
(PHR) is that the more consumers know about
their health, the more control they will take
over it and the healthier they will be.
• PHRs also encourage consumers to collect
and share more health-related information with
each of their providers.
• For this reason, healthcare providers,
employers, insurers, vendors, and the federal
government are all interested in promoting
PHRs.
• Consumers will hear much more about the
personal record in the months and years
ahead.
Courtesy: AHIMA Personal Health Record Practice Council. "Helping Consumers Select PHRs:
Questions and Considerations for Navigating an Emerging Market." Journal of AHIMA 77, no.10 (November-December 2006): 50-56.
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What is a PHR?
• No standard definition
• AHIMA proposed a PHR definition in
2005:
– “The personal health record (PHR) is an electronic,
universally available, lifelong resource of health
information needed by individuals to make health
decisions. Individuals own and manage the
information in the PHR, which comes from
healthcare providers and the individual. The PHR is
maintained in a secure and private environment,
with the individual determining rights of access. The
PHR is separate from and does not replace the legal
record of any provider.”
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Types of PHRs
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•
•
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Paper
PC
Internet
Hybrid
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•
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•
•
•
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Employer
Insurer
Provider
Public Health
Government
Independent for-profit
Independent non-profit
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Questions
• Content
– Demographics, insurance, advance directives, donor,
medications, allergies, problem lists, events, hereditary,
immunizations, etc.
• Interoperability
– Connected? Standalone?
• Ownership
– Privacy policies?
• Access
– Privacy and Security?
• Portability
– Usability?
• Cost
– Business model?
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HIENs and PHRs
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•
•
•
•
•
Operator
Education
Policy
Oversight or Rating
Convener
Data Exchange
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High-level Strategy
When opportunities arise, how do we evaluate their
priority for us? How do we develop strategy?
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Step 1: Evaluating
Themes
Disease Mgmt Personal
Health
Records
Electronic
Health
Records
Sustainability
Broad Use
Consistent with VHITP
Objectives and Principles
Quality Improvement
Efficiency
Public Image
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Step 2: Utilize VITL
Infrastructure
Disease
Mgmt
Personal
Health
Records
Electronic
Health
Records
CDR
EMPI
Security
Normalization
Auditing
Interfacing
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Architecture
Web-based
Patient Portal
Topical Registry or
Application
Data Mgmt
System
Message
Hub
Internet
Web-based
Provider Portal
Central Infrastructure
Originating
System View
Integration Engine
Message
Hub
Interface
Engine
EMR/
PMS
HL7
Internet
Support for
HL7, X12,
NCPDP
Formats
Central Services
HL7
Data
Locator
Service
Web
Services
Terminology
Service
LDAP
Security
Service
HL7
Doc
Locator
Service
HL7 or
SQL
Data
Service
Terminology
DB
Rights
Registry
Doc
Shared
and/
Registry/
EMR or
or
Repository
Warehouse
Rx
HL7
Patient
Locator
Service
Medicaid
Lab
SQL
Note: Presence of
centralized or
distributed data will
vary based on
project/subject matter
and not participant.
Payer
MPI
Clinical Data Repository
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Step 3: Implementation
Strategy
• Environment Analysis (is the service
being met already? Are organizations
prepared to offer the service?)
• Strategic Development
• Priorities
• Future business
• Revenue/Expenses Analysis (ROI)
• Feasibility
• End user feedback
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Potential Strategy
• Project Review Committee
• Use the three stage process
– Identify priority areas
– Select strategic pilots that best exercise the
architecture (both technical and non-technical)
– Over time we can adjust focus
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