Innovations and Trends in Health Care: The Advent and Use of Personal Health Records (PHRs)

My semester-long research project in HSCI 2109 is about the advent and use of a very interesting innovation in health care: the Personal Health Record (PHR). This presentation is a mid-semester check-in with my fellow students to educate them about some key definitions, stakeholders, barriers, and recommendations I have gathered around system development and the implementation of PHRs.

I have a version of this slide deck with talking points since this was an e-presentation through a distance learning curriculum. I am happy to share them with you if you'd like.

This is a topic I am very interested and invested in so I would be happy to discuss it with anyone who is interested!

http://twitter.com/skram | http://linkedin.com/in/silverbergmark | mark@socialhealthinsights.com

Transcript

1. PERSONAL HEALTH RECORDS A Facilitated Discussion by Mark Silverberg HSCI 2109 - Trends and Innovations in Healthcare - GW Spring 2013
2. TOPIC INTRODUCTION Personal Health Records (PHRs) are an Innovation in Health Care • The topic of PHRs is a perfect example of how information technology has the potential to enrich the health care experience • PHRs have the potential to catalyze patient engagement which has been shown to cut costs and improve outcomes through both preventative medicine and chronic disease management (PCMH model) Electronic Health Record Personal Health Record Definition Maintained by contains the encounter data between a health provider and the patient includes patient information they have received from their providers plus data they enter themselves Provider or Payer Patient
3. KEY STAKEHOLDERS • Patients stand to gain insight into their own health and improved outcomes if their PHR provides the right functionality. Security breaches would, however, put patients’ own information at risk (however they already at risk due to EHR use which is beyond the patient’s control) • Providers can benefit by having a more knowledgeable and informed patient. Some providers could see this as a larger burden and more work. Providers can benefit from government incentives in some cases. Retrieved 4/6/2013 from http://www.deloitte.com/view/en_BE/be/industries/ life-sciences-and-health-care/life-sciences-and-health-care-in-belgium/ • Payers benefit when their costs are reduced. PHRs do this by letting patients manage chronic diseases and encouraging preventative measures; may pay for PHRs • IT service providers can benefit economically from building products and providing services but must comply with security regulations such as HIPAA
4. BARRIERS TO ADOPTION Providers • Attitudes including lack of buy-in (Anoshiravani 2011) • Practitioner difficulty with technology (Miller 2004) • High up-front costs for IT (Miller 2004) Patients • Lack of information, motivation (Goel 2011) • Negative attitudes towards technology, security concerns (Goel 2011)
5. FACILITATORS OF PROGRESS Technology • Advancements in technology continue to make PHRs more viable through secure data exchange and improved user experience design Payers • Due to the savings and subsequent improved profit margin, payers may continue to subsidize PHRs for their patients to encourage healthy (and cost-saving) behavior and choices Government leverage on providers • Regulations including some Meaningful Use measures require providers to make patient portals available to patients in order to receive incentives. It is thought this will be the first step to get patients used to managing their care and holistic health online.
6. SUSTAINABILITY & ECONOMICS • A PHR is controlled by a patient but it can be hosted by any trusted party • Some receive a PHR through their employer, payer, provider, or health club. • There are free and paid options in the marketplace for patients to choose from. Popular examples include Microsoft HealthVault and NoMoreClipboard. • Implementation costs for PHRs vary greatly. There are some open- source software packages which can be used to significantly reduce costs. • Providers are economically incentivized by the government (Center for Medicare and Medicaid Services) to implement EHRs and PHRs.
7. COST AND BENEFITS FOR INDIVIDUALS AND SOCIETY • With correctly implemented and supported PHRs, improved health outcomes and reduced costs can be achieved; a few examples include: • reminding and urging patients to receive preventative medicine such as flu shots and colonoscopies (Lau 2012) • allow patients to ask medical professionals non-urgent questions without calling or coming into the office (Detmer 2008) • facilitate chronic disease management using online, mobile, and device- connected tools (Urowitz 2012) • connect patients to cost-saving telemedicine providers • A 2008 article from the Journal of the American Health Information Management Association (JAHIMA) noted that “widespread use of PHRs could save the US healthcare industry between $13 and $21 billion a year.”
8. IMPORTANT CONSIDERATIONS There has been a lot of credible research performed on the topic of PHRs. Future researchers and system implementors should take advantage of the existing wealth of knowledge including these suggestions: • Good user interfaces not only make for a more enjoyable experience but also increase data quality (Kim 2004) • Most popular features were usually found to be medication overview and lab results sections followed by the treatment appointments feature (Ros 2012) • Patients are most likely to engage with the PHR technology if the practitioner who explains it to them ‘buys into’ the pitch (Lee 2006) • Organizational change management cannot be underestimated (Bonander 2010); it may be as or more important than the technology itself (Day 2012)
9. RECOMMENDATIONS • Having a PHR puts the patient in a position to more effectively monitor and impact their own health. Doing so can help more than just the patient. • PHR system developers and implementors must keep patient and practitioner needs and feelings in mind throughout the process “Having a Personal Health Record keeps me in control of my family’s healthcare.” Retrieved 4/6/2013 from https://www.mymediconnect.net/