birds of a feather phr
DESCRIPTION
Birds of a Feather PHR. HL7 - Phoenix Tuesday, Q5 EHR/PHR WG John Ritter, Elaine Ayres, Tim Mckay. Agenda. Introduction and Welcome High-level display of the new PHR-S FM functions for nutrition and physical activity The PHR and Mobile Health - PowerPoint PPT PresentationTRANSCRIPT
© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Birds of a FeatherPHR
HL7 - PhoenixTuesday, Q5
EHR/PHR WGJohn Ritter, Elaine Ayres, Tim Mckay
© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Agenda Introduction and Welcome High-level display of the new PHR-S FM
functions for nutrition and physical activity The PHR and Mobile Health Nutrition, PHR, EHR, and Mobile Devices
-- The Future is Now! Q&A, Status, Issues, and Next Steps
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© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Description of the Nutrition and Diet Information Section
Nutrition is related to health and wellness as well as chronic diseases. People want to record and monitor their food and nutrient intake including any nutritional supplements because they are trying to manage their weight, maintain their fitness level, or demonstrate progress towards the goals in their nutrition care plan.
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Examples of Nutrition & Diet Information
Food and nutrient intake records Liquid nutrition supplements (nutraceuticals) Enteral and parenteral feedings Vitamin, mineral and herbal supplements History of breastfeeding Diet recommendations provided by a Registered Dietitian Tracking information such as weight, height, and Body
Mass Index (BMI) Food allergies and intolerances Physical activity records
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Criteria 1 1a. The system SHALL provide the ability for the
PHR Account Holder to manage information regarding the PHR Account Holder's nutrition and/or diet.
1b. The system SHALL provide the ability for the PHR Account Holder to manage concerns (either self-generated concerns or concerns that were expressed by others) that relate to the PHR Account Holder's nutrition and/or diet.
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Criteria 2 2a. The system SHOULD provide the ability for the PHR Account
Holder to capture his or her nutrition and diet information (specifically, current intake of foods and/or nutrients).
2b. The system SHOULD provide the ability for the PHR Account Holder to capture his or her nutrition and diet information (specifically, past history of intake of foods and/or nutrients (e.g., anorexic during teenage years; vegetarian from age 5 to 10).
2c. The system SHALL provide the ability for the PHR Account Holder to import diet and nutrition -related data from a provider's EHR system or from other sources (e.g., diet-related instructions from a provider; diet-related orders; or diet-related information that appears on an assessment).
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Criteria 3 3. PHR system SHOULD allow for entry and
tracking of nutritional supplements, multivitamin and herbal products as discrete data or lists.
Question – should this be merged with other medication functionality?
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Other Criteria Analyze drug-herb interactions and render a
notification or alert Analyze and render nutritional information by
calculating nutrient values for items or total daily intake summaries
Exchange food intake information and/or nutritional analysis data with third-party applications
Capture, maintain, and render physical activity information including total workout data
Capture, maintain, and render educational information
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Use Case 1 The PHR-S maintains a food and nutrition
history list that may be followed by the PHR Account Holder and referenced by his or her providers and Registered Dietitians.
Copies of the PHR food and nutrition history list may be kept by their providers in their EHRs.
01/01/20119
© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Use Case 2 The PHR-S maintains a list of nutrition and
diet-related information including food intake records, nutrient analysis summary records, energy balance data and nutrition care recommendations.
This list may be followed by the PHR Account Holder and referenced by his or her providers including a Registered Dietitian
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The PHR and Mobile Health The PHR/Mobile Gap Analysis Sub-group was established
to determine the extent of changes needed in the PHR-S Functional Model to accommodate the use of mobile devices within the model.
Scope: Review recently balloted PHR-S functional model to
determine how the introduction of mobile devices as actors within the model may result in changes to the model.
Make specific recommendations to the PHR-S functional model in terms of additional conformance criteria and/or creation of a mobile-specific profile for the PHR-S.
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PHR/Mobile: Completed Work The team has generated a bulleted list of
issues to use in determining the need for changes to the PHR-S.
Items fall into three overlapping categories Device characteristics (location services, camera,
accelerometer, screen size) Device context (location of use, BYOD, destination vs.
conduit) User actions (shared devices, device misplacement)
© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
PHR/Mobile: Next Steps Review the PHR-S Chapter 3 conformance
criteria to determine need for new/updated criteria.
Consider the need for a mobile-specific PHR-S profile in light of the Chapter 3 review.
© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
The PHR and Mobile Applications
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Mobile optimized page vs. mobile application
85% of US adults own a cell phone – of those 53% own smart phones
© 2012 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
What if……… Your smart phone is your PHR?
Utilize various applications Collect data (or information) from various
apps and transfer to the mobile PHR PHR then provides reminders,
suggestions or calculations PHR enables transfer to other systems
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How Many Apps? According to MobileWalla (this morning)
13,110 Health Apps 475 Diet and Nutrition Apps 3534 Exercise and Physical Activity Apps 574 PHR Apps!!
My Fitness Pal has over 30 million users 19% of all smart phone users have a health app
and of those exercise, diet and weight apps are the most popular (Pew Internet) 11/12
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Mobile Phones Phones – texting reminders like Text4Baby
Low and Middle Income Countries (LMIC) Often mobile phone only source of information Use for notifications Use for reminders
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Smart Phones Weight Management Use Case
Establish a goal for weight and body mass index in the weight management app
Record weight data on a weekly basis NOTE: may use a smart scale to provide weight
data directly to app Record daily food intake in a “diet” app
Monitor daily caloric intake Collect data in PHR (or PHR app) PHR provides educational information on weight loss
tips and behavior modification
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Smart Phones Shopping Use Case
A Diabetes management app develops a shopping list with suggested foods
An embedded bar-code reader captures all of the foods purchased
A list of foods purchased is recorded and sent to the PHR
The Registered Dietitian reviews the list of food purchased as a way to monitor compliance
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Smart Phones Vitamin/Mineral/Herbal Supplement Use
Case A supplement tracking app records use of
vitamins, mineral and herbal supplement use The list of compounds used is added to the PHR The PHR sends the list to the EHR Prior to upcoming surgery, patient notified to
discontinue herbal supplement use based on adverse impact on anesthesia
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Smart Phones Physical Activity Use Case
Physical activity app measures daily exercise routines
Point of care testing for blood glucose tracks daily blood sugar levels
Data is transferred to PHR PHR correlates and graphs relationship of
exercise in managing blood glucose levels
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Smart Phones Allergy and Intolerance Use Case
Junior eats some nuts at home and develops a rash around his mouth
Mom takes a picture with her phone and sends to her PHR app
Mom heads to the emergency room where an allergy to nuts is added to Junior’s allergy list
The allergy list is then updated in the PHR and includes the associated reaction photo
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In Closing….
Q and AStatus of projectNext steps
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