Emerging Trends in Health Information Technology: Personal Health Record(PHR) uphr. Nazir Ahmed Vaid ehealth Services (Pvt) Ltd.

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Milo Chapman
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1 Emerging Trends in Health Information Technology: Personal Health Record(PHR) uphr Nazir Ahmed Vaid ehealth Services (Pvt) Ltd. April

2 PROJECT GOALS Design universal health data accessibility on mobile devices such as USB, Smart Phone Global interoperability and freedom of move for the health/ medical records. Requirement to achieve the goal: Design HL7 compliant PHR as per HL7 functional model. HL7 - CDA (Clinical Document Architecture) compliant storage for medical data and referenced documents like discharged summary, medical history, lab results Special purpose browser to view and update medical records on physician s computing system. Authentication and authorization mechanisms in order to ensure the secure and legitimate access to medical data.

HL7 - CDA (Clinical Document Architecture) compliant storage for medical data and referenced documents like discharged summary, medical history, lab results

3 Personal Health Record PHR (Personal Health Record) a health record where health data and information related to the care of a patient is maintained by the patient include information such as Chief complaints Laboratory reports Medication list Chronic diseases Illnesses and hospitalization Allergies etc

by the patient include information such as Chief complaints Laboratory

4 PHR on USB: uphr PHR on a USB. The clinical data lies on the USB which is synchronized with cloud server. The data is secured through authentication, authorization and encryption. The USB can be plugged and play at a care provider center for view and data entry.

5 Outstanding features of uphr Ubiquitous User Friendly Touch Screen Dash Board view for Medical Professionals Drop down menus Auto Completion Health Life Horizon (HLH) 5

6 Outstanding features of uphr Internationally Recognized Protocols guiding Doctor and Healthcare professionals for next steps Extensive Digital Library Bio ID including Face and Voice recognition Complete Financial Solution incorporated Complete Insurance Solution included Health Life Horizon (HLH) 6

Library Bio ID including Face and Voice recognition Complete Financial

7 Outstanding features of uphr CDSS Clinical Decision Support System LBB Language Barrier Breaker erx Electronic - translated and graphic Prescription Appointment/Scheduling Solution SMS/ /VMB Alerts PDA/Smart Phone/Tablet Versions Health Life Horizon (HLH) 7

and graphic Prescription Appointment/Scheduling Solution

8 Related Medical Records Electronic Medical Record (EMR) created, managed, shared and controlled by health care providers or institutions Electronic Health Record (EHR) collected from many different EMR s and PHR s and sharable among health information systems

institutions Electronic Health Record (EHR) collected from many

9 Benefits of PHR Detailed summary of patient health status at one place Paperless record, so no folder and storage expenses Secured record, taking care of the privacy issues Easy accessibility, one click away Record regular input from the patient itself

Secured record, taking care of the privacy issues Easy

10 PHR Evolution (Chilmark Model) PHR PHM /PHS / PHP Presented to Federal forum as part of kicked off to the Federal PHR standardization committees 10

11 PHR System Data Space Personal Information: individual, family, health care providers and contact info, insurers, history, pets) PHR System Complaints (problem list) Diagnosis, Procedures, Lab results Immunizations, Allergies Medications, Advance Directives Nutrition and diet, Exercise Personal commentaries Information Resources (literature, glossaries, encyclopedias, webpages, listserves)

results Immunizations, Allergies Medications, Advance Directives Nutrition and diet, Exercise

12 Patient PHR System Data PHR System Demographics Vital Signs Medication List Test Results Problem List Allergies Insurance Procedures Immunization

14 Scenario 1 Patient goes to a hospital having only HIS with no HL7 standard Physician Hospital Information System uhealth Card Entry Interface CDA Provide interface to Physician/Patient in order to enter the required information Generate CDA document linked with hospital generated document.

Interface CDA Provide interface to Physician/Patient in order to enter

15 Scenario 2 Patient goes to a hospital having no HIS Patient goes to the hospital, gets the treatment. Takes hard copies of the documents (e.g. prescription, discharge summary etc.), scans and copies into the USB. Uses the entry interface to enter only required data extracted from scanned document. uhealth Card system links the scanned document in appropriate sections and generate final CDA document.

16 Scenario 3 Patient goes to a hospital having CDA compliant HIS Patient goes to the hospital, inserts the USB into the system. The CDA document from the HIS is received and integrated into the uhealth Card automatically. CDA Document CDAs CDA Compliant HIS

The CDA document from the HIS is received and integrated into

Scenario 3 Patient goes to a hospital having HL7 V3 messaging compliant HIS Patient goes to the hospital, inserts the USB into the system. HL7 V3.0 message from the HIS is sent to USB and then it is parsed.

17 Scenario 3 Patient goes to a hospital having HL7 V3 messaging compliant HIS Patient goes to the hospital, inserts the USB into the system. HL7 V3.0 message from the HIS is sent to USB and then it is parsed. The parsed objects will be automatically placed into USB, using some Mapping Bridge. Hospital Information System Dat a HL7 Message HL7 Message Mappin g CDA

0 message from the HIS is sent to USB and then it is parsed.

18 Backup Service Design Designed a web service for client to server communication Backup Server uhealth Card Backup web service Persist Data Fetch Data Backup Database

19 Folders Hierarchy Configuration uhealth Card Data Note: All the data folders can only be accessed via uhealth Card application uhealth Card application should run automatically Common Integrated PHR Patient Records Insurance Shifa Maroof SKM Reference Files Reference Files Reference Files

should run automatically Common Integrated PHR Patient Records Insurance Shifa-

20 Application Scenarios: Functional Models Simple Application scenario The PHR of an individual is on the USB. This has been achieved and we are piloting at Maryam Hospital. Insurance part and Backup design are under progress. Distributed Application Scenario The actual data is stored on Cloud USB (smart card) provides authentication and authorization only. This may be useful in West. Hybrid Application Scenario Vital signs are on USB along with authentication and authorization More sensitive and critical data is stored on the Cloud Integratable with care provider EMR and EHR systems Integration with EHR and EMR

Distributed Application Scenario The actual data is stored on Cloud USB (smart card) provides authentication and authorization only.

21 Application Scenario: PHR as a Hospital EMR USB 1 Patient 1 Private Cloud: EMR System USB 2 Patient 2 Patient 1: e Folder USB 3 Patient 3 uhealthcard Aggregation Patient 2: e Folder USB Patient USB n Patient n Patient n: e Folder Care Provider EMR

22 PILOTING AT MMH Doctor Registration Form Name Specialty Qualification (Degree) Hospital Contact No Username Password

23 Medical History Viewing date-hospital- Physician

24 THANKS

Custom Report Data Elements: IT Database Fields. Source: American Hospital Association IT Survey

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