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Personal Health Record and web 2.0
 

Personal Health Record and web 2.0

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Personal Health Record and web 2.0: a new way for patients and citizen to collect, handle, and share their own health data - Presented at the XVI Congress of International Federation of Health Record ...

Personal Health Record and web 2.0: a new way for patients and citizen to collect, handle, and share their own health data - Presented at the XVI Congress of International Federation of Health Record Organizations - Milan, Italy November 18, 2010

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    Personal Health Record and web 2.0 Personal Health Record and web 2.0 Presentation Transcript

    • Personal Health Record and web 2.0: a new way for patients and citizen to collect, handle, and share their own health data Eugenio Santoro eugenio.santoro@marionegr.it Laboratory of Medical Informatics Department of Epidemiology Istituto di Ricerche Farmacologiche “Mario Negri” E. Santoro - IFHRO 2010, November 18 2010
    • AHIMA Definition of PHR"The personal health record (PHR) is an electronic, universally available, lifelong resource of health information needed by individuals to make health decisions. Individuals own and manage the information in the PHR, which comes from the health care provider and the individual. The PHR is maintained in a secure and private environment, with the individual determining the rights of access. The PHR is separate from and does not replace the legal record of the provider.“AHIMA e-HIM Personal Health Record Work Group. "The Role of the Personal Health Record in the EHR." Journal of AHIMA 76, no.7 (July-August 2005): 64A-D. http://www.webcitation.org/5Vlj7zE7EIFHRO 2010, November 18 2010 E. Santoro -
    • Personal Health Record – Key points• A PHR is different form an electronic health record (EHR) that is maintained by the health care provider/hospital/physician• PHRs are stored in a private, secure, centralized databases located on web servers• A PHR is under control of the patient. The owner of the PHR can decide: - Which information are to be collected/uploaded - Who can wiew them - With whom share them (family members/physicians ..) E. Santoro - IFHRO 2010, November 18 2010
    • Which health data a PHR should include - 1 • Patient demographics (including name and date of birth) • Emergency contacts (family members, physicians, specialists, dentists) • Health insurance information • Important events and hereditary conditions in family history • Opinions of specialists • Important tests results (laboratory, radiological, etc.) AHIMA E. Santoro - IFHRO 2010, November 18 2010
    • Which health data a PHR should include - 2 • Eye and dental records • Correspondence between the patient and his health providers • Dates of significant illnesses and surgical procedures • Current medications and dosages • Discharge summaries • Medicine and allergy lists • Immunization status and dates • Data about life style and habits (e.g. smoking, weight, height, bmi, etc.) AHIMA E. Santoro - IFHRO 2010, November 18 2010
    • PHR - Data collection• Manually by the owner of the PHR• Automatically by the owner of the PHR • home glucometer • blood pressure readings • other devices• Other providers (if an agreement exists) • pharmacies • labs • health care providers • EHR/EMR E. Santoro - IFHRO 2010, November 18 2010
    • Some tools provided by the PHR systems - 1 • Checking for drug interaction as soon as medications are uploaded • Checking for drug/allergies interaction • Home monitoring and management of health parameters (e.g. weekly/monthly graph of blood pressure) • Scheduling of appointments with physicians • Reminders for health screening programs (diabetes, cancer, etc.) E. Santoro - IFHRO 2010, November 18 2010
    • Some tools provided by the PHR systems - 2 • Medication refill and renewal • Communications with the physician (secure messaging) • Community alerts and social networks • Sharing with family members/physicians • Links to reliable health information systems for medical education E. Santoro - IFHRO 2010, November 18 2010
    • PHR Systems: Option 1 Stand alone: the user can enter, modify and update everything PHR © Gunther Eysenbach, CC-BY Based on: Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. J Am Med Inform Assoc. 2006 Mar-Apr;13(2):121-6 E. Santoro - IFHRO 2010, November 18 2010
    • PHR Systems: Option 2 Tethered: the user can view his health information from a EHR system Read onlyEMR PHR Read+Write/ AnnotateEMR PHR © Gunther Eysenbach, CC-BY Based on: Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. J Am Med Inform Assoc. 2006 Mar-Apr;13(2):121-6 E. Santoro - IFHRO 2010, November 18 2010
    • PHR Systems: Option 3 Integrated: the user can view and enter information into his record that can be shared or added to his medical record (EHR) EMR PHRDifferent providers PHR EMR PHR © Gunther Eysenbach, CC-BY Based on: Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. J Am Med Inform Assoc. 2006 Mar-Apr;13(2):121-6 E. Santoro - IFHRO 2010, November 18 2010
    • Google Health E. Santoro - IFHRO 2010, November 18 2010
    • Microsoft HealthVault E. Santoro - IFHRO 2010, November 18 2010
    • Dossia E. Santoro - IFHRO 2010, November 18 2010
    • UK NHS HealthSpace E. Santoro - IFHRO 2010, November 18 2010
    • Usage of PHR systems - 1• Consumers with online access to their health information pay more attention to their health• PHR usage (in US) is low (7%), but doubled in two years.• PHR users are young (11%), highly educated (12% college graduated)and higher income (13% with >75.000$), frequent Internet users (12%), suffering from 3+ chronic conditions (9%) CALIFORNIA HEALTHCARE FOUNDATION 2010 E. Santoro - IFHRO 2010, November 18 2010
    • Usage of PHR systems - 2 • Less educated, lower-income and chronically ill patients report greater value from using a PHR • Two out of three Americans are concerned about the privacy of their health information; concern is reduced by experience with and benefits received from a PHR.CALIFORNIA HEALTHCARE FOUNDATION 2010 E. Santoro - IFHRO 2010, November 18 2010
    • Reasons limiting the use of the PHR systems CALIFORNIA HEALTHCARE FOUNDATION 2010 E. Santoro - IFHRO 2010, November 18 2010
    • Advantages – Patient/Consumer• Complete medical history stored in one place• Centralization of health data• Access data from anywhere (e.g. while traveling)• Access data in case of emergency (by himself or by ER physicians)• Automatic notification of scheduled activities (medical visits, drug administration/assumption)• Home care monitoring and self-management of own health conditions• Improving of the doctor-patients communication E. Santoro - IFHRO 2010, November 18 2010
    • Promises/Drivers of PHR2. Preventing Medical Errors “The single most important way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results.“ (AHRQ) PHRs can help to engage patients in their care. E. Santoro - IFHRO 2010, November 18 2010
    • Advantages – Physician/Hospital• Access to patients complete medical history• Checking of drug interactions• Limitation of medical errors• Reduction of the cost of care (avoid duplication of examinations or prescription of drug already taken by the patient) in patients suffering from chronic diseases• Identification of patients at risk E. Santoro - IFHRO 2010, November 18 2010
    • Promises/Drivers of PHR1. Public health, prevention, behavior change• PHRs as an entry point for behavior change programs (e.g. smoking cessation, obesity)• PHRs as an entry point for customized health recommendations• PHRs can be used as surveillance tools Evaluation of Influenza Prevention in the Workplace Using a Personally Controlled Health Record: Randomized Controlled Trial Florence T Bourgeois, William Simons, Karen Olson, John Brownstein, Kenneth Mandl J Med Internet Res 2008 (Mar 14); 10(1):e5 E. Santoro - IFHRO 2010, November 18 2010
    • Advantages – Reseacrh• PHRs may be a particularly valuable to study relationships between health behaviour and outcomes• PHR could be used to selection possible candidates to be included in clinical trials based on their health conditions (consent for this secondary data use should be obtained by the patient) E. Santoro - IFHRO 2010, November 18 2010
    • Disdvantages• Data may be uncompleted, inaccurate, difficult to verify, in particular when they are collected by the patient• High heterogeneity among the PHRs systems - low interoperability between PHRs and PHRs/EHRs systems• (patient’s perceived feeling of) scarce security and privacy about his/her health data - Patients express concerns that the data could be accessed by unauthorized people E. Santoro - IFHRO 2010, November 18 2010
    • Characteristics of PHR 2.0“PHR 2.0” have “Web 2.0” design features that enable / facilitate participation, collaboration, and openess - Model social relationships between individuals - Open standards - Acknowledge consumers as “prosumers” - Ability for consumers to share parts of their health records with anybody E. Santoro - IFHRO 2010, November 18 2010
    • PHR 2.0 EMR PHR Other peoples’ PHR PHR Other peoples’ PHR EMR PHR Other peoples’ PHRDifferent providers Community E. Santoro - IFHRO 2010, November 18 2010 © Gunther Eysenbach, CC-BY
    • Patientslikeme E. Santoro - IFHRO 2010, November 18 2010
    • Conclusions• PHR’s are a fundamental means of providing value driven healthcare• Adoption rates are low but it is expected they rise in the next years• To obtain more advantages PHR systems must be completely interoperable in order to allow sharing of data between them and between EHR systems• PHR 2.0 could add further advantages E. Santoro - IFHRO 2010, November 18 2010
    • Thank you Eugenio Santoro eugenio.santoro@marionegri.it www.twitter.com/eugeniosantoro http://eugeniosantoro.wordpress.com http://www.youtube.com/eugeniosantoro http://www.slideshare.net/eugeniosantoroSantoro E. “web 2.0 e medicina”. Roma 2009,Il Pensiero Scientifico editore E. Santoro - IFHRO 2010, November 18 2010