Basic overview of Patient Portals, Personal Health Records, and how they work with Electronic Health Records. Presented at the Partnership With Patients Summit in Kansas City September 22, 2012. Learn the pros and cons of various ways to manage your health information.

1. Where Do I Put My Damn Data?
Patient Portals and PHRs
Joe Ketcherside, MD
President & CEO, Cognovant Inc.
Partnership with Patients Summit
Kansas City MO, September 2012

2. How do I get my health data?
 There are different ways to get your data
 View of some or all data in a provider’s Electronic Health
Record (EHR)
 Download a file or printout data from a portal
 Paper reports generated by your provider
 Copies of paper-based records and reports
 Challenges exist in getting data from multiple
providers
 It’s difficult to keep up-to-date

3. Where do I keep my health data?
 Box in a closet
 Paper copies in a file
 Patient portal
 Provider keeps the data, but I have access
 Personal Health Record (PHR)
 Key difference between patient portal and PHR – you’re
in control, you manage the data
 Different kinds of PHRs
 Tethered PHR
 Web-based independent PHR
 Mobile independent PHR

4. EHR vs. PHR – What’s The Difference?
 An EHR is a business record a provider uses to deliver
care in a hospital, health system or office
 Clinical and administrative staff enter the data
 Used for billing and all clinical activities
 Record of your care in that organization
 A PHR is used by an individual person to manage their
health information
 P stands for Personal
 You enter your data and manage the content
 This is a record of your care across time and place
 Though there is overlap, these are significantly different

5. Patient Portals
 Often a feature of a provider’s Electronic Health Record
 Lets a patient view some or all of their data in the record
 Generally just a subset of the complete record
 Only contains information in that EHR
 Most provide additional administrative features
 Secure communication with providers
 Appointment requests
 Refill requests
 Access to educational info or care plans
 Doesn’t let you enter your own data
 Doesn’t move with you when you change providers

6. Tethered PHR
 Tied to a provider’s EHR, employer or insurance
company
 Does let you enter and track your own data
 Usually populated by the source system
 Most also provide administrative features
 Doesn’t contain data from providers outside of the
source system
 Doesn’t go with you when you change provider
systems or insurance

7. Web-based independent PHR
 PHR system hosted independently
 Microsoft HealthVault, Google Health (RIP)
 Database lives on host’s servers, so they control it
 Access via browser or mobile device
 You manage the data yourself
 Some may link to providers, pharmacies or other
sources
 Less likely to have administrative connection to
providers
 You still have it if you change providers, job,
insurance

8. Mobile independent PHR
 PHR system runs locally on mobile device
 Database is locally hosted
 You control your health data
 Contains data from multiple sources
 You can share data with your providers
 May be able to import data from EHRs
 Moves with you when you change providers, jobs,
etc.
 Less likely to have administrative features

9. Value of PHRs
 All your health information in one place
 PHRs aggregate data from multiple sources
 Longitudinal picture of your health, not just one provider
 Complete and consistent source of truth
 Tools to track important data like blood pressure, weight,
medications, etc.
 Share patient-sourced data with providers
 Potential for links to educational resources and
communities or care
 Critical information in an emergency

10. Barriers to PHRs
 Number one barrier is the current difficulty of
gathering and entering data
 It’s difficult to keep up-to-date once entered
 Security and privacy concerns
 Tethered PHRs usually don’t contain data from other
providers
 Challenges understanding medical terminology
 How do you share the data with providers?

11. Impact of Stage 2 Meaningful Use
 EPs must provide patients the ability to view online,
download, and transmit their health information within 4
business days of the information being available to the
EP
 EH and CAH must provide patients the ability to view
online, download, and transmit information about a
hospital admission within 36 hours of discharge
 Transmission of health information is to another provider
or to a PHR
 Stage 3 expected to require EHRs to incorporate patient-
sourced data
 This will be the key to reaching the potential of PHRs