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TRANSCRIPT
Cynthia Solomon, CEO - FollowMe CTRC 2013 Telehealth Summit - April 16, 2013
Personal Health Records Paving the Way to Continuity of Care
Consumers have high expectations for gaining
electronic access to their medical information
Consumers assume information is easily transferred between providers and hospitals
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High Hopes, High Expectations For Realizing the Benefits of Health IT in Today’s Landscape
Information Exchange 1999 2
EMRs, EHRs, and PHRs Fragmented Paper Information Now Fragmented Electronic Information
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Personal Health Records (PHRs) contain the same types of information as EHRs—diagnoses, medications, immunizations, family medical histories, and provider contact information—but are designed to be set up, accessed, and managed by patients.
Electronic Medical Records (EMRs) are a digital version of the paper charts in the clinician’s office. An EMR contains the medical and treatment history of the patients in one practice. Patient access to an EMR may be available via a provider’s portal.
Electronic Health Records (EHRs) contain information from all the clinicians involved in a patient’s care. All authorized clinicians – including pharmacists & specialists - can access the information to provide care to that patient.
Patient Portal 1 Patient Portal 2
EMR 1 EMR 2 EMR 3 EMR 4
EHR 2 EHR 1
Patient
PHR
Meaningful Use Mandate Facilitating Patients’ Active Management of Care
Meaningful Use Requirements Include Consumers Reporting on Clinical Quality Measures
o Patient and Family Engagement o Patient Safety o Care Coordination o Population and Public Health o Efficient use of Healthcare Resources o Clinical Processes/Effectiveness
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Paving the Way PHRs as Vehicle For Accelerating Continuity of Care
PHRs as a Tool
Aligning with CQM Health Policy Domains
Mutual Benefit for Doctors and Patients
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FollowMe
Pioneering CA-based company, developed one of first PHRs in 1999
Targeting underserved & vulnerable populations o Foster Youth – HealthShack™ o Teenage Parents - FollowMyChild o Migrant Workers – MiVIA o Chronic Disease Patients – FollowMyHeart
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WIND Youth Services
Community Providers
UC Davis Medical & Health
Home
Member Data & Documents Input: • Health • Education • Employment • Housing
•Administrators •Outreach Workers •Youth Ambassadors
Youth Members
Adult Advocates & Allies
Doctors, Nurses, Therapists, Specialists
HealthShack.info
Database Server
Web/App Server
HealthShack Website
Link Via Provider Website
(read-only access)
HealthShack Website
Link via WIND Website
Content & Tools: • Resume Builder • Emergency ID Card • Trusted Resources • Website/Blog • Social Network Links • Video & Audio • Permissions & Consent
File Server
Funders: Sierra Health Foundation, UnitedHealth Group
HealthShack™ Patient & Family Engagement at WIND Youth Services in Sacramento
HealthShack™ Today
Private Agencies o Aspiranet (CA – THP Program)
o EMQ Families First (CA)
o WIND Youth Services (CA)
o Lutheran Social Services of Northern California
o Our Kids/Miami-Dade County (FL)
Public Agencies o Placer County (CA)
Healthcare Providers o UC Davis Health System (CA)
AltruIT Stewardship Product Development
o Mobility o Interoperability
Forward Focus o CA Counties o Transitioning Populations o Research Opportunities
Current Users Current Initiatives
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Electronic Medical Passport Evaluation Project
Having nurses available to guide the foster parents was essential
Health care providers were very satisfied upon receiving a Passport for a new foster child patient
The Passport needs to optimize the workload of the nurses, while providing a resource for the parent/kids
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FollowMyChild Patient & Family Engagement for Foster Kids in Florida
MiVIA Patient Safety for Migrant Workers in Sonoma Valley
Focus on uninsured and transient populations lacking a medical home
Eliminates geographic barriers in primary, speciality and tertiary care
Patient education and advocacy tools
Members create their own personal HIE, sharing information between providers and family members
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Chronic Care Coordination
One of the most critical issues around
coordinated care is that of transitions - from tertiary care to community-based care, from pediatric care to adult-centered care
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FollowMyHeart Care Coordination for Heart Patients and Doctors
Congenital heart disease (CHD) is the most common birth defect worldwide. There are now more than 1,000,000 adults in the United States living with CHD.
The FollowMyHeart PHR is the result of a team effort between Children’s National Medical Center, Washington Hospital Center and FollowMe to help patients manage CHD for life by providing a system to enter, store, and share their medical histories.
Research: o Electronic Personal Health Record Use in Adolescent and Adult Congenital Heart
Disease Patients (submitted) Linda B. Tiernan, MD, Munziba Khan, MPH, Anitha S. John, MD, PhD, Karen S. Kuehl, MD, MPH, Department of Cardiology Children’s National Medical Center Washington D.C.
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FollowMyHeart Care Coordination for Heart Patients and Doctors
Heart module stores scans, heart reports, EKG results
Features CHD-specific educational content
Members control access to data
Facilitates communication between CHD patients and providers
Patients find helpful in emergencies and when living away from original site of cardiac care
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Lessons Learned
Education Outreach
Implementation
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Key Challenges for PHR Adoption
Technology o Overload in approach to 2014 o Interoperability o EMR Pushback
Literacy o Lack of awareness of PHRs o Consumer literacy lags ACA implementation
Sustainability o Funding to support community-level involvement o Monetizing product while maintaining trusted environment
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What If… PHRs as Vehicle For Accelerating Continuity of Care
We implement a layer of consumer services that
includes the PHR to align with HIE implementation efforts via a “Consumer Health Hub”
We integrate telemedicine services and medical device innovations as components of Consumer Health Hub
We provide a “virtual medical home” using the PHR as the tool promoting continuity of care
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Visualize the Consumer Health Hub 17
Health Information Exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically. There are currently three key forms of health information exchange: • Directed Exchange – ability to send and receive secure information electronically between care providers to support coordinated care
• Query-based Exchange – ability for providers to find and/or request information on a patient from other providers, often used for unplanned care
• Consumer Mediated Exchange – ability for patients to aggregate and control the use of their health information among providers
Source: www.healthit.gov National Learning Consortium
Thank You! 18
Putting a Face on Consumer Engagement
CONTACT US www.altruit.com/healthshack
Contacts
www.mivia.org - Cynthia Solomon, CEO, FollowMe – [email protected]
www.altruit.com/healthshack - Barbara Sorensen, CEO, AltruIT – [email protected]
www.followmychild.org - Pat Smith, VP, CIO, Our Kids of Miami-Dade/Monroe, Inc. – [email protected]
www.followmyheart.org - Linda Bradley Tiernan, MD, [email protected]
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Bibliography Articles, Research, Outcomes
Personal and Electronic Health Records o Meaningful Use Data and Case Studies from The Office of the National Coordinator for Health Information Technology,
http://www.healthit.gov/providers-professionals/meaningful-use-case-studies#patient_family
o “Access to Mental Health Data in EHRs Linked to Lower Readmissions,” January 2013,http://www.ihealthbeat.org/articles/2013/1/4/access-to-mental-health-data-in-ehrs-linked-to-lower-readmissions.aspx#ixzz2HPg7e7wM
o Project HealthDesign – Phase II: Grantee Technical Architectures and Implementations, December 2011, http://www.projecthealthdesign.org/resources/reports/technical-architectures-and-implementations-report
HealthShack o “Bright Idea: Youth Input Helps Design Online Repository for Personal Records,” November 2012,
http://ncfy.acf.hhs.gov/the-beat/2012/11/youth-build-online-repository
o “Web-Based Service Helps Runaway and Homeless Adolescents Feel More Empowered About Health, Enhances Access to Quality Care,” February 2011 (last updated May 2012), http://www.innovations.ahrq.gov/content.aspx?id=2982
o “HealthShack: An Online Health Resource for Youth Without Roots,” April 2010, http://www.ucdmc.ucdavis.edu/welcome/features/20100407_HealthShack/index.html
Transitioning Youth in Foster Care o “Providing Foster Care for Young Adults: Early Implementation of California’s Fostering Connections Act,” 2013,
http://www.chapinhall.org/research/report/providing-foster-care-young-adults-early-implementation-california’s-fostering
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