Download to read offline
Uploaded byPatients Know Best
From transparency to collaboration
This document discusses increasing patient access and involvement in their own healthcare records. It provides examples of three initiatives: the Swedish National Patient Portal, OpenNotes from the US, and Patients Know Best from the UK and Netherlands. OpenNotes allows patients access to visit notes online. A study found 99% of patients wanted continued access and 85% said it would influence future provider choice. The document proposes "OurNotes" which would allow patients to contribute directly to the medical record by providing information for visits. It outlines a pilot study to evaluate the impact on workflow and whether doctors and patients want to continue such a model.
More Related Content
Similar to From transparency to collaboration
From transparency to collaboration
- 1. From transparency tocollaboration taking patient accessible records to the next level Maria Hägglund Associate professor, Karolinska Institutet Mohammad Al- Ubaydli CEO at Patients Know Best Jan Walker, RN, MBA & Tom Delbanco, MD, Co-Founders OpenNotes
- 2. 03/05/2018Maria Hägglund @mariahagglund2 Swedish National Patient Portal • National Information Exchange Platform • Sweden OpenNotes – a movement • Not a technical platform • US Patients Know Best • patient-controlled medical record • UK and the Netherlands 3 examples
- 3.
- 4. The virtual portalfor patients/citizens Facts and advice Rules and patient rights Find care Facts and advice Find care E-services Book an appointment or renew a presciption? Search for illness or treatment… 6,8 million visits/month!
- 5. eHealth services Messages Careproviders Act as proxy Other services Online health record Medications All other services 4 604 235 persons have logged in = 46% of the population use this service
- 6. Online Electronic HealthRecord Record notes Medications Lab results Warnings Maternity care Diagnosis Referrals Vaccinations 1,8 million users have logged in = 18% of the Swedish population 48 000 persons log in/month
- 7. Online Electronic HealthRecord Record notes Medications Lab results Warnings Maternity care Diagnosis Referrals Vaccinations 1,8 million users have logged in = 18% of the Swedish population 48 000 person log in/monthhttps://www.inera.se/aktuellt/statistik/journalen_statistik/
- 8. Online Electronic HealthRecord
- 10. What are OpenNotes? (Delbanco,Walker, et al, Ann Intern Med, 2012) Open notes are visit notes that patients can access online through providers’ patient portals. “How can patients participate if they can’t see what I see?” -- Danny Sands, MD (It’s a concept, not software)
- 11. About OpenNotes Beganwith three-institution study in 2010 at Beth Israel Deaconess Medical Center, Geisinger Health System, and Harborview Medical Center: 100 PCPs and 20,000 patients Now an international movement to make OpenNotes the standard of care
- 12. 99% ofpatients wanted to continue 85% of patients said availability of open notes would influence their future choice of providers. At the end of the 12-month study, no PCP stopped All 3 participants decided to implement institution-wide New results coming in 2018 The Bottom Line
- 13.
- 14.
- 15. 2018: 21+ millionpatients have access to notes Primary care, specialists, mental health, pediatrics, MDs, NPs, PAs, PTs …
- 16.
- 17.
- 18.
- 19.
- 20.
- 21.
- 22.
- 23.
- 24.
- 25.
- 26.
- 27.
- 28.
- 29.
- 30.
- 31.
- 32.
- 33.
- 34.
- 35.
- 36. CONSIDER A SPECIFICCARE PATHWAY – HOW COULD THIS BE USED THERE? - risks? - benefits?
- 37.
- 40. Looking ahead: OurNotes Patients, families contribute to notes, as a permanent part of the record An idea percolating for several years • Could having patients author part of the note increase their understanding and engagement? • Could this save doctors time? Begin with pre-visit • Interim history • Priorities for this visit
- 41. Preparing for yourupcomingvisit with Dr. Smith on 9/1/18 at 2:00pm Patient name: Jane Doe Dateof Birth: 1/1/56 MRN: 123456 PCP: Dr. Smith As part of the OurNotes effort in which you and your doctor are participating, please prepare for your visit by answering the following questions. 1. Please tell yourdoctorhowhaveyou been since last visit. You may want to include changes in symptoms affecting your health, in the way you are taking medications, in your habits, or other changes in your life. To help guide what you write, we suggest you also read your doctor’s last note, focusing in particular on previous plans or recommendations. Optional: click here (TO opennotes team: should pop up a separate screen) If you run out of space, please continue below. 2. What issues would you like to focus on at yourvisit? We suggest you limit what follows to the 2 or 3 things on your mind that are most important to you. (300 character limit) 3. Please review yourmedication list to make sure it is accurate. 1,000 character limit 1,000 character limit 1. 2. 3.
- 42.
- 43. OurNotes (Delbanco, Walker, etal, Ann Intern Med, 2012) 12-month pilot in 4 sites What we would like to learn • Will patients complete these tasks? • Will providers find the information useful? • PCPs’ perception of workflow impact • Do both doctors and patients want to continue?
- 44.
- 45. 03/05/2018 46 HOW CANWE MAKE THIS HAPPEN? Challenges? Benefits? Improvement suggestions? Who needs to be involved?
- 46. Thank you foryour attention! Contact KI / Journalen Maria Hägglund, Associate Professor in Health Informatics Maria.Hagglund@ki.se DOME consortium web site: https://domeprojekt.wordpress.com DOME on Twitter: @domeprojekt Contact OpenNotes: myopennotes@bidmc.harvard.edu www.opennotes.org Contact Patients Know Best: Mohammad Al-Ubaydli mohammad@patientsknowbest.com
Editor's Notes
- #5 447 435 km² 1 572 km from north to south, about 500 km wide Inera koordinerar landstingens och regionernas gemensamma e-hälsoarbete i enlighet med Handlingsplan 2013-2018. Landstingen är autonoma. INERA utvecklar tjänster till nytta för invånare, vård- och omsorgspersonal och beslutsfattare Tillsammans med andra aktörer bidrar vi till att realisera Nationell eHälsa - strategin för tillgänglig och säker information inom vård och omsorg. Målet med strategin är att stödja och effektivisera vården, stärka patientens ställning samt skapa god tillgänglighet till vården. I handlingsplanen finns både en målbild för 2018 och årsvisa mål. Staten Sverige består av 290 kommuner och 20/21 landsting/regioner Vi har autonoma landsting och de lägger alla ut information på olika sätt.. NYA INERA: Inera - landsting och regioner i samverkan för e-hälsa Tidigare var Inera ett utförarbolag som fick uppdrag via landstingens beställarkansli Center för eHälsa i samverkan, CeHis. Under 2013 beslutade ägarna att inte ha längre ha en beställar-/utförarmodell så från 2014 bildar CeHis och Inera en gemensam organisation med namnet ”Inera - Landsting och regioner i samverkan för e-hälsa”. Bolaget leds av en styrelse med två politiker från respektive sjukvårdsområde. Vd ansvarar för bolagets verksamhet och har till sitt stöd en ledningsgrupp. Ineras omsättning 2013 var 306 miljoner kronor. Den totala omsättningen för CeHis och Inera var cirka 600 miljoner.
- #6 The virtual portal for patients/citizens is in operation since 2002 under the brand “Mina vårdkontakter” (My care contacts). Within the portal, you can choose which county council you wish to access information from, and you will have adapted information. You can also log in to have access to your personal e-services.