Personal Health Records PHRs: The Best Therapy for Patient Access to Health Information - PowerPoint PPT Presentation

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Personal Health Records PHRs: The Best Therapy for Patient Access to Health Information

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Personal Health Records (PHR) are a disruptive and transformative phenomenon ... But: Differ from EHR's (top-down) Software systems designed for HC Providers ... – PowerPoint PPT presentation

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Title: Personal Health Records PHRs: The Best Therapy for Patient Access to Health Information


1
Personal Health Records (PHRs) The Best Therapy
for Patient Accessto Health Information
  • ARTC Symposium Privacy in Health Services and
    Policy Research
  • St Johns NL
  • April 20, 2009
  • David A Townsend
  • UNB, Fac of Law

2
Thesis of presentation
  • Personal Health Records (PHR) are a disruptive
    and transformative phenomenon (bottom-up)
  • PHRs offer excellent potential to avoid
    hospitalization doctor visits, improve patient
    outcomes and save billions in healthcare dollars
  • Doctors, Hospitals Governments should
  • Integrate PHRs into their Electronic Health
    Record (EHR) implementations
  • Include them within data exchange plans
  • Protect PHRs within Personal Health Information
    legislation

3
What are Personal Health Records (PHRs)?
  • No exact definition exists
  • Notion has existed for over 30 years (1978)
  • Current notion
  • computerized application that stores personal
    health information in a digital format
  • But Differ from EHRs (top-down)
  • Software systems designed for HC Providers
  • Data entered, maintained controlled by HC
    Providers
  • Limited Patient controls over what is entered,
    accessed exchanged

4
What are PHRs? More
  • Personal Health Records
  • Record is usually initiated by Patient
  • Health data is personally entered by the Person
    to whom record relates, or a loved one
  • Usually contain health information about drug
    reactions, allergies, medications,
    hospitalizations, test results, family medical
    history, etc.
  • Often contain a personal e-log of
    self-administered medications medical tests and
    reactions
  • Some offer secure Internet portal for medical
    consultations, e-mailing, searching alerts
  • E.g. Google Health MS Health Vault
  • KEY Patient controls entry, amendment sharing

5
Adding EHR data to PHR data?
  • Patient records have been discrete, paper files
    protected by physical access controls,
    legislation and professional ethics
  • Healthcare Providers have created the files and
    assumed owner-like custody over them
  • Patients have been given limited access to them
    and little control over their content
  • Yet, in 1992 the SCC ruled that the physical
    record belongs to the Provider, but the
    information within belongs to the Patient.
  • BUT Provincial PH I statutes do not apply to
    PHRs important legal implications

6
Who are Likely Users of PHRs?
  • Technology Adopters
  • Young people now collect, store and access
    information in order to direct their own
    financial, social and professional lives. They
    expect direct involvement in HC managment
  • Chronically ill gain the most from PHRs
  • Eg. Asthma, Arthritis, Diabetes, Heart disease
  • Frequently interact with HC system looking for
    healthcare health information (are most
    dissatisfied with HC system)
  • Guardians or Designees who provide HC to loved
    ones - Women, Women, Women.
  • Documentation improves HC decision-making
    outcomes

7
PHRs and Role of HC Providers and Governments?
  • Patients come to HC Providers for two things
  • 1- Healthcare and 2- Health Information
  • Enormous HC resources are expended for each
  • BUT Knowledge stimulates responsibility-taking
  • Patients or their Designees can actually
    Partner with HC Providers
  • -proactively engage in curing and preventative
    activities
  • -track, log adjust care activities according
    PHR data.
  • -request, search out create relevant HC data
  • Billions of dollars in HC savings are possible
  • NB Select Committee on Wellness July 2008
    highlighted importance of taking responsibility
    for personal children's wellness

8
Example of HC Savings
  • Eg. Chronically ill Patients
  • 40 of population has chronic illness (13M
    Canadians) Eg. Asthma, Arthritis, Diabetes, Heart
    disease
  • In Canada, that 40 of population accounts for
    70 of HC Spending (100B in 2006)
  • Informed and proactive Patients can prevent,
    delay onset, treat and log data for most chronic
    illnesses
  • Address problem of preventable doctor visits
    and hospitalizations

9
Concluding comments
  • PHRs offer excellent potential to avoid
    hospitalization, improve patient outcomes and
    save billions in healthcare dollars
  • Doctors, Hospitals Governments should
  • Integrate PHRs into their Electronic Health
    Record (EHR) implementations
  • Include them within health data exchange plans
  • Protect PHRs within Personal Health Information
    legislation
  • Atlantic govts need women-focused strategies

  • Thank you.

10
Canadian Medical Association (CMA)
www.mydoctor.ca
  • First Physician-driven PHR (top-down)
  • Secure web portal between Doctor and Patient -
    secure email between them
  • Trusted health websites booked in browser
  • Patients encouraged to track log asthma
    treatments, blood pressure, blood sugars, weight,
    etc.
  • Doctor can preset alerts - critical data points
  • Current Stats - total of 500 PHR sites created by
    40 doctors since April 1, 2008

11
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12
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13
Evolution of PHR Offerings
  • Medic Alert - early but limited PHR
  • Early PHRs were not User-centric
  • ROI for platform developer very uncertain
  • - Microsoft and Google changed everything
  • MS HealthVault - 2007 Google Health - 2008
  • Free simple, consumer-centric products
  • Both agreed to integrated platform for exchanges
  • Both partnering with Employers HC Providers
  • Other US developers RevolutionHealth, WebMD,
    Dossia Intuit
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