Home > HealthIT, Meaningful Use > Will PHRs (Personal Health Records) Play A Crucial Role For Meaningful Use?

Will PHRs (Personal Health Records) Play A Crucial Role For Meaningful Use?

Even as CMS is finalizing the Stage 2 policy of the Meaningful Use incentive program, the Health IT Policy Committee Meaningful Use Workgroup is working on the recommendations for Stage 3. MU stage 3 includes new objectives and increased thresholds for existing Stage 2 NPRM objectives. One of the focus areas is to increase the involvement of patients and families/caregivers in managing their own health.

One of the related new objective’s in Stage 3 is inclusion of Patient Generated Health Data (PGHD). Research and inputs from physicians indicate that PGHD is extremely useful to improve the quality of care. This further gets emphasized for chronic and complex conditions like diabetes. PGHD can be broadly classified into two types. One is data provided by the patient using home monitoring devices like BP Monitors, Glucose meters, etc. The second is more related to the patient describing her/his own health. Of course this could be free text inputted by the patient, family or care-giver. However, the information becomes more valuable when this information is captured in a structured form. ODL (Observation of Daily Living) is one such form. ODLs can include information related to quantity and quality of sleep, moods experienced, level of pain experienced by the patient, etc.

Another example of an objective related to involving patients and families is the patient having access to health records. Stage 1 and Stage 2 already have objectives to allow patients to download health information with the “Blue Button”. The Blue Button idea began when the department of Veterans Affairs (VA) allowed their patients to download their health data. Since then, the idea has expanded and many health care provider groups and other organizations have signed on to allow their patients to download health data via the Blue Button. The first step toward automating the Blue Button is by developing standards and specifications that would allow users to not only download their health information, but also to automate the sending of that data from their health care providers to other data repositories.

How do patients/families interact electronically with their providers today?

So how do the patients interact with their providers to download/transmit heath data or reconcile their demographics information? Today most providers have a web-service called “Patient Portal”. Some hospitals which are ahead in the IT curve also provide mobile apps. For e.g. Mayo Clinic has an app on iOS called “Patient App”. Using either the desktop browser or the mobile app (if the provider has one) the patient can secure message with his/her care team, download health records, schedule appointments, etc. So for PGHD the logical extension would be to enable inputting PGHD via the patient-portal.

Where do PHRs come in?

It’s common knowledge that a person does not deal with just one doctor or one hospital through his/her lifetime. Patients, families and caregivers deal with family practitioners, specialists (like cardiologists, nephrologists, etc) and different hospitals at various times during their lifetime. Just consider the process from pregnancy to child-birth to caring for the child. A mother will initially consult her internist or gynecologist. She then deals with her gynecologist through the next nine months. During this time she will interact with labs and hospitals. It’s possible she might change her gynecologist in the early stages or even later due to various factors. A simple reason could be re-location. Once the child is born the parents will now consult a pediatrician along with initial follow-ups with the gynecologist for the mother. Once again, it’s possible that the parents decide to consult a different pediatrician. The point I’m making is that a person during her/his lifetime will have consulted innumerable number of providers. At each stage patients and families will electronically interact with the provider. One such mode is the patient portal. However, each provider has their own patient portal. Just imagine doing reconciliations, providing PGHD, downloading and collating health data across multiple patient portals. This is where I believe a PHR becomes the crucial aggregator and collaborator tool for patients, families and caregivers. It will be the one-stop-shop tool through which the patient/family or caregiver can manage health information through the entire continuum of care. Most importantly the patient can choose the PHR tool provider just like how one can choose his/her email provider.

PHRs in what form?

Microsoft Health Vault like technologies need to evolve to meet the need mentioned above. Features which are missing today even in patient portals will need to be incorporated. One such example is patient education related to his/her current conditions which is not just literature but multimedia immersive. PHRs will need to seamlessly interwork with the various providers EHRs and patient portals. People like to multi-task today. Pure desktop based solutions limit people to a place and time. Mobility is a very crucial factor. Imagine the role of families and caregivers. An example is a daughter managing the care-coordination of her father. She needs to be able to access her dad’s records and health information while on the move.

There’s lot of buzz and activity in American HealthIT with the federal officials working on policies and standards. What is important at the outset is to see improvements in quality and affordability of healthcare. I would love to hear your comments and views. Do let me know your opinions on the future of PHRs.

Categories: HealthIT, Meaningful Use
  1. Shweta Singh
    December 8, 2015 at 1:08 PM

    nice selection of professional healthcare blogs. but still i think there is one site i found a year later doing legendary work in healthcare IT field. they’re doing innovative work in the field of PHR (completely free – which i personally use to store my health records) along with amazing information on various health topics : http://mediklik.com/

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