PHR Presentation

Personal health records: Helping consumers take the driver’s seat Michael Matthews National e-Health Leader National Health Services Practice

A Canadian health consumer survey was conducted in 2009 highlighting the behaviours, attitudes, and unmet needs in areas of health consumerism
A survey was conducted to better understand the perspectives of public and patients as healthcare consumers.
Research focused on the behaviours and motivations of health consumers in making choices as they interact with the healthcare system.
A conceptual framework was used, reflecting the six major domains of healthcare consumer activity providing input into the consumer’s perspective for personal health records
Health Consumer Survey Framework
The survey was conducted online between October 29 – November 12, 2008.
74 questions and 46 potential follow-up probes: behaviours were asked before attitudes and unmet needs to reduce respondent bias
All 10 provinces were surveyed, but the territories were not included
The total sample size included 2,304 adults:
The sample is nationally representative matched to age, gender and race/ethnicity
Health Care Consumerism

Survey results revealed that consumers are spurring the demand for personal health records across Canada
Centres around the consumer
Offers self-care, self-management and learning capabilities
Is offered through a trusted source and secured from privacy breaches
Provides a flexible platform for a consolidated view of a patient’s health
This calls for a personal decision-support model that…
Over 65% of respondents feel it would be beneficial to have access to the PHR of a family member whose care they are helping to manage
Over 60% of respondents are interested in a PHR or online medical record provided by their doctor’s office, hospital and government

Over the years, PHRs have evolved information management functionality to meet the needs of consumers
A personal health record can be initiated, maintained and/or supplemented by health care consumers. It reaches beyond the traditional paper charts and EMRs to include prescriptions, test results, wellness and other demographics deemed necessary by the consumer.
Level of functionality Examples Information collection: Aggregates data from multiple and external data sources Patient diaries; Family history; Supplemental health information Information sharing: Allows patients and others to view health information Laboratory/radiology/test result viewing; Viewing notes taken by the provider during a visit; Sharing of health information summary sheets Information self-management: Allows patients to learn about, monitor and/or manage own health and health of others Reminders for health care events and maintenance; Disease management plans; Health care education; Tracking of health care expenses/billing Information exchange: Allows patients to engage in automated data exchange transactions with others regarding their health / health care Health care support groups; Appointment scheduling; Pre-visit and post-visit care management questionnaires; Medication management; Secure messaging with health care professionals (e-visits)

While consumers stand to gain significant benefits from PHRs, so do health care providers and governments
Success of PHRs will depend on the participation of stakeholders across the health system
Key players Motivation Benefits Consumer
Empowered to provide physicians with a complete picture of their personal health history
Promote improved quality of care through information sharing
Share PHR information with a family member, friend, or provider via the delegation option
Engage and self-manage health and health care
Focus on prevention and continuous monitoring
Consolidated source of health care information
Government
Improve resident health, thereby increasing productivity and lowering absenteeism
Use PHRs to reinforce health and wellness
Eliminate duplicate tests and unnecessary hospital admissions
Reduce errors
Engage consumers
Provide a single view of consumer health
Reduce overall costs through a more health conscious consumer and appropriate use of hospital/clinic visits
Health providers
Provide critical documentation in emergency situations
Reduce clinical errors through access to accurate, relevant data
Serve as a back-up data source to assist with disaster recovery operations
Enhance provider productivity and improve use of resources

The success of these entrants is dependent on strategic enablers to address the key issues faced today Change management Clinical process redesign Education Technology enablement Today “Pre-PHR era” Enablers Future “PHR era” Consumer
Limited confidence in health record security
Limited access to electronic or paper health data
Challenges in care and information management for chronic disease
Challenges for family caregivers to manage health information and connect with care team
Trust in health data security
Varying levels of need for and acceptance of PHR functionality and complexity
Individual family caregiver access and increased involvement with care team
Lower barriers to switching care providers
Organization and people
Provider-centric
Individual provider or organization-based
Face-to-face provider-patient interactions
Consumer-centric
Interdisciplinary team and multi-organization-based
Increased frequency of PHR-based e-communications and e-consults

The success of these entrants is dependent on strategic enablers to address the key issues faced today (cont’d) Electronic data standards Legislation EHR/EMR implementation e-Reimbursement models Today “Pre-PHR era” Enablers Future “PHR era” Information technology and infrastructure
Mixed paper/electronic health records
Organization/provider-controlled IT and health data
Fragmented hospital, lab, diagnostics, drug, physician and other data
Mixed federal/provincial health information and privacy legislative requirements
Increased numbers of organizations/providers with EHRs/EMRs
Integrated or interoperable electronic health data that feed a PHR
Provider-based PHRs, Government-based PHRs, Vendor-based PHRs
Need for consistent privacy/security legislation across Canada
Health care reimbursement
Reimbursement schedule that supports traditional face-to-face patient care
Individual professional payment model
Shift to e-visit/consult reimbursement
Support for team consult reimbursement models

In the midst of evolving times, its imperative for your organization to consider its readiness to meet the needs of its consumers
As organizations prepare for the PHR and consider related investments, they will need to consider their overall readiness across several dimensions including their organization, stakeholders, broader environment, and approach to implementation as seen in the checklist below:
How ready is your organization in terms of culture and infrastructure? How willing are your stakeholders, consumers and healthcare providers, in participating in this innovation? What is the state of personal health record (PHR) readiness for your external stakeholders? Have you defined your method for implementing PHRs? (e.g. technology platform of choice, funding source, change management philosophy, and consumer engagement process?) What is the appropriate funding model you plan to use for your organization’s PHR?      Personal health records readiness checklist

For more information, please contact:
Michael Matthews National e-Health Leader [email_address]
Mark Fam Deloitte Center for Health Solutions [email_address]
Lisa Purdy National Health Consulting Leader [email_address] Ian Tait Public Sector Technology Leader [email_address]

Deloitte, one of Canada’s leading professional services firms, provides audit, tax, consulting, and financial advisory services through more than 6,800 people in 51 offices. Deloitte operates in Québec as Samson Bélair/Deloitte & Touche s.e.n.c.r.l. The firm is dedicated to helping its clients and its people excel. Deloitte is the Canadian member firm of Deloitte Touche Tohmatsu. Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, its member firms, and their respective subsidiaries and affiliates. As a Swiss Verein (association), neither Deloitte Touche Tohmatsu nor any of its member firms has any liability for each other's acts or omissions. Each of the member firms is a separate and independent legal entity operating under the names “Deloitte,” “Deloitte & Touche,” “Deloitte Touche Tohmatsu,” or other related names. Services are provided by the member firms or their subsidiaries or affiliates and not by the Deloitte Touche Tohmatsu Verein. © Deloitte & Touche LLP and affiliated entities.

PHR Presentation

by mgmatthews on Jan 29, 2010

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