Personal health records (PHRs) combine patient data, knowledge, and software tools to help patients actively participate in their own care. PHRs can be standalone systems maintained by patients, tethered to access institutional records, or interoperable across multiple systems. While 75% of consumers want online access to medical records and test results, current PHR utilization in the US is only around 2-3% due to barriers like difficulty finding and using PHR systems and a lack of valuable clinical content beyond data storage. Health systems that have integrated robust PHR portals into their electronic medical record systems have seen much higher adoption rates, up to 34% in some cases, demonstrating that ease of access and useful functions are key to

1. Personal Health Records Connecting the Healthcare Experience

2. Roadmap What is a Personal Health Record (PHR) Definition, Components, & Goals Terminology Market Market Size & Benchmarks Providence Future Directions

3. What is a PHR?

4. Functional Components

5. Patient Applications More than just static repositories for patient data Combine data, knowledge, and software tools Help patients to become active participants in their own care

6. PHR Goals

7. Terminology Stand Alone – Limited to patient-entered and maintained information Tethered PHR – Allows patients to view information from other applications (e.g. Institutional EMR) Interoperable PHR – Accessible to and through multiple systems Bi-directional PHR – Two-way communication between EMR and PHR

8. Repository vs. PHR

9. Adoption Potential 75% of consumers want access online Medical records Test results Appointment scheduling 1 in 4 willing to pay extra 60% would use a PHR if available

10. Cross-Industry Comparison Online banking 27% growth rate in 2005 72 million households (76%) by 2011 85% of “Gen Y” will bank online Similarities and Differences Technical - security, privacy, sharing Information complexity and need for interpretation

11. Current Utilization 25% of Americans have PHR access Currently 2-3% actual overall utilization Barriers to adoption: Difficulty finding, using or understanding PHR’s Lack of “Value” content – beyond data storage

12. Current Utilization Higher adoption rates in specific systems Lower adoption in repository-only systems Function layers drive utilization Ease of access and use are key drivers

13. Aetna Using ActiveHealth Partnered with HealthVault Installed in mid-2007 7% PHR adoption April 2009 (18 mo)

14. SSM Healthcare of Wisconsin Using Epic MyChart 650 providers 1.1 million EMPI records 0  30,000 active users after 18 months 30% growth during last 6 months

15. Kaiser Using Epic’s MyChart 34% PHR adoption (3M users and 8.3M members) within 3 years Lab results viewed 150K  10M+ Clinician messaging 74K  3.5M+ Patient portal repeat users 20%  60%

16. Providence PHR Registration 200,000 members 3,000 PHR registrants 1.5% adoption

17. Providence PHR Utilization Utilization data is for the last 2 years of WebMD implementation

18. Functional Components

19. Current Providence PHR Claims based data source On-site data repository One-way data flow Some targeting possible PHR Applications Application Programming Interface PHR Data Repository AdministrativeData Source Clinical Data Source Patient Entered Data Security Protocol Security Protocol

20. PHR and Connect Rx Hub SureScripts Non-Providence Providers PHR Patient Providence HIE Cerner Lab Star Radiology HCS IS Centricity Horizon Clinicals 3 rd Party Repository Admin Server Flowcast Pathways Inpt Sched

21. Shift Away From Claims? “ Sharing billing data with patients is unreliable for clinical history, and it was a mistake to do that” - Dr. John Halamka, CIO Beth Israel Deaconess April 2009

22. Shift Away From Claims? Google now working with National Library of Medicine to codify free text clinical terms

23. Claims Data Value

24. Summary PHR’s are a fundamental means of providing value driven healthcare We are currently falling behind benchmarks in PHR application and adoption rates Developing a bidirectional, integrated PHR puts Providence at the front of Healthcare IT

25. Questions?