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What Value Does a Healthy Patient Get from a PHR?

Posted on November 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In my previous post about a Patient Controlled Medical Record, I asserted that such a thing would be a challenge to get to work in the US, but that there was a lot of potential internationally. I did provide one caveat when it came to chronic patients where I think there is potential in the US as well. Although, some argued against even that group being interested in the comments.

Let me further expound on why I think the patient controlled medical record fails for a healthy patient (and this includes people who think they’re healthy, or at least relatively healthy…ie. they don’t go to a doctor for any chronic condition). In many respects this is my talking from my own personal perspective as a young, healthy adult (although I guess all of those descriptors could be argued).

The problem for someone that’s healthy is that their medical record basically has no data. The reason you want a patient controlled medical record is so that you can extract value from the data. I don’t need to look at my online medical record to see that I don’t have any drug allergies, that I had a cold or flu 3 years ago, that I got my flu shot 4 years ago, and that when I was 15 I had a hernia operation.

The point being that my medical record is so short that there’s so little value in me trying to aggregate that record in once place. What value do I get from doing so?

I think there could be value in doing so, but not today. For example, if by keeping a patient controlled medical record I could avoid filling out the crazy stack of paperwork that’s given you at every new doctor you visit, I and every other patient would want to keep an online patient record. This should be a solvable problem, but I won’t go into the hundreds of systemic reasons why it’s not going to happen anytime soon. Although, we’ll start with the doctor preferring your allergies to be in the upper right corner in red. Now scale that request up to 700,000 doctors.

Similar to the above item, there are other ancillary functions (ie. appointment scheduling, prescription refills, message your doctor, etc.) that could be tied to your medical record that would make people want to use a PHR or other similar system. However, most people would use it for the ancillary functions and not to be able to control their medical record in one place. For many of the ancillary services this portal will need to be tethered to a PHR.

One trend that I hope will change my description above is the wave of new health sensors that are hitting the market. As those health sensors get better I believe we’ll see a new type of portal that is attractive for even a “healthy” person to visit. This concept coincides with what I call Treating a Healthy Patient. All of this new sensor data could make it worth my time as someone who thinks I’m healthy to check and aggregate my data in one location. The volume of data available would be much more than what I have stored in my memory and so it will make sense for me to visit somewhere that stores and processes my whole medical record.

How these portals full of health sensor data will work with doctors is a topic for another blog post. Until then, I’ll be surprised how many healthy patients really get on board collecting their patient data in a patient controlled medical record.

Making the Case for Healthcare Data Interoperability

Posted on November 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My post titled “Patient Controlled Records Could Work Internationally” has driven a lot of interesting conversation in both the comments and my email inbox. I want to highlight some of the responses in a few future posts. The responses do a really good job extending the conversation around a patient controlled health record.

One example of this is from regular reader and commenter R Troy (Ron). As I mention in my post, I think that the patient controlled medical record can work for chronic patients, because they care about their care. R Troy’s comment does a good job explaining a couple examples of why chronic patients can really benefit from having and controlling their patient record:

I am sure that you are quite correct; people in good health have far less interest in maintaining their own health records, except perhaps for those who are fanatics who want to track everything.

As you may have guessed, I have chronic problems – in my case asthma and allergies primarily. And one family member is T1D, and another has a serious auto immune disorder. The latter in particular is part of my passion for EHR’s – I believe that treatment would be far better handled and the results understood with EHR’s with analytical capabilities. Same reason I want a good PHR capability – because that illness plus my issues demand having good data when an emergency occurs, or you move to a new doctor.

A few years ago, the family member with the immune disorder had been scheduled for outpatient treatment at Hospital X. The night before, that person needed to get to an ER ASAP. We wanted the ambulance to go to the ER at X. But there was a bad winter storm, and the ambulance took the person to Hospital Y, in a separate hospital system.

It took Y a few days to get sufficient paper records faxed over from X and from the treating doctor to properly care for the patient, making the situation even worse, and very wasteful cost wise. While HIE would greatly have helped, so would a viable PHR that was well populated and very readily and quickly accessible at Y. BTW, I’m not sure if X and Y are yet able to communicate (the doctor is still not live on an EHR), but I am quite sure that the EHR used in the ER at X (which the patient uses from time to time) has only minimal connections to the EHR used by the rest of hospital X.

One of my HealthIT instructors had orthopedic work done at hospital Z, with lots of imaging. A short time later, he found himself in the ER of hospital X – which could not access any of the imaging from Z, which now had to be completely repeated. Both wasteful and dangerous.

If HIE’s were ‘universal’, at least in the US, the need for a PHR would mainly revolve around the patient’s need to see all their info in one container, plus to get at it from outside the US if the need came up. But it would still exist.

We won’t go into all the challenges of the universal HIE here, but until those challenges are solved. You can see the value of a chronic patient having their universal health record that they can share no matter where they go for healthcare.

Patient Controlled Records Could Work Internationally

Posted on October 31, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A few years back at HIMSS, I had the pleasure of meeting one of the most passionate and driven healthcare people you’ll find. His name is Gerald Theis, Founder of My Crisis Records. His passion for what he was doing was undeniable and there was no way I was going to bet against Gerald getting something done in healthcare. However, I did question how many US patients would really care enough to carry around and gather their health records.

Turns out, there are dozens of companies with a vision similar to that of My Crisis Record. I’m sure that Gerald could passionately explain why My Crisis Record is different or better than any competitors, but at the end of the day the core concept is very similar: A patient controlled health record.

Whether the patient controlled health record is carried on a USB stick, linked from a QR code, stored on your cell phone, accessed in the cloud, etc the concept is the same. In many ways the patient is acting like their own personal health information exchange.

The concept is a brilliant one except for one major flaw. US people don’t care about the flow of their healthcare information. The big exception to this is chronic patients who do start caring once they get past the denial stage. However, the majority of patients in the US are satisfied with the current flow of information between doctors. Certainly their satisfaction could be based on ignorance. Many patients likely think that doctors are sharing a patients health information all the time, when in fact they are usually not.

Could this change? Certainly, but it’s hard to base a business on people changing.

What I’ve found even more interesting is Gerald’s work to implement a My Crisis Record solution internationally. For example, he’s implementing it under the brand “My Smart Health” in Africa. The more I’ve learned about international healthcare, the more I think a patient controlled record could work internationally in places where they’re more focused on providing any sort of health services versus spending big bucks on EHR systems that aren’t interoperable.

All of this is bolstered by the widespread adoption of cell phones internationally. I can see how there could be real value in a patient controlled medical record on these people’s cell phones. From what I understand, you might not go to the same doctor twice. There’s not the same view of a primary care doctor that you go to all the time that has your record at their fingertips. Seems like the perfect opportunity for the patient controlled medical record.

We’ll see how it plays out. I guess I’m not very bullish on the patient controlled medical record in the US, but I can see a lot of potential globally. Maybe over time the US will learn and change as well. What do you think?