VistA and Personal Health Records

Size: px

Start display at page:

Download "VistA and Personal Health Records"

Felix Kelly
3 years ago
Views:

What type of diseases are consumers pushing to have?
What type of services have students of medical economics long realized that consumers demand?
What do faxes archive?

1 VistA and Personal Health Records José C. Lacal Chair, IEEE2407 Personalized Health Informatics Visiting Professor, OpenPHI, Kingston University (UK)

2 Table of Contents Framing this Talk About Health Informatics Why Personalized Health Informatics? OpenPHI Platform HealthAlbum CRM: Consumer Health HealthAlbum Solution HealthAlbum vs. Current PHR Offerings Why EMR <=> PHR? Demo

OpenPHI Platform HealthAlbum CRM: Consumer Health

3 Framing this Talk: Health Healthcare..students of medical economics have long realized that what consumers demand when they purchase medical services are not these services per se but rather better health. [01] Family as the unit of care. Live long and prosper; then check out quickly. More healthcare for all is T scalable. More health for all is very scalable. From: Let's improve the healthcare system for all. To: A care system that improves the health of all.

are not these services per se but rather better health. [01] Family as the unit of care.

4 Health Informatics Early-stage Florida-based Products and services: bio-informatics startup. Free software for Mission: consumers to manage family's health help build a care custom development system that enhances every family's health. consulting, integration reduce barriers to use pre-loaded computers vast health databases, About José C. Lacal: publications, know-how Technologist & Public empower consumers Health Entrepreneur. to leverage own ICTs. 43 yr old; 21 yr IT exp. Philosophy: Open Access; rd 3 start-up; Fortune 50 Open Code; Open Data.

health. consulting, integration reduce barriers to use pre-loaded computers vast health databases, About José C.

5 How Would You Like a Colonoscopy? Consumers really want to reduce the odds of needing the procedure.

6 Healthcare-designed Automobiles All consumers would pay the same rate, regardless of driving record. Listing of best body shops in your area. Massive social investments to develop car repair tools, equipment. Repair shops would be reimbursed even if car is not fixed. Repair shops will tout their Electronic Car Record. Publish guidelines for evidence-based vehicle repair. Repair shops will connect to a carrhio. Average cost of car repairs across state. Repair shops open Mon-Fri, 09:00 to 17:00 hr. only.

Repair shops would be reimbursed even if car is not fixed. Repair shops will tout their Electronic Car Record.

7 Engineering-designed Automobiles Source: Bosch s website.

8 Why Personalized Health Informatics? Consumers want control over health data: social and economic pressure less trust in providers need to improve healthcare's delivery systems, methods consumer-driven healthcare (HSAs) high-deductible plans care coordination for life-long chronic diseases Consumers pushed to own their health data: few EMR deployments privacy of outsourced health data processing health data floating around (RHIOs) with no Consumer control Need to migrate from a provider-centric model towards a Consumercontrolled model of health improvement.

methods consumer-driven healthcare (HSAs) high-deductible plans care coordination for life-long chronic diseases Consumers pushed to own

9 Family-Centered

OpenPHI Platform Browser-based Consumer UI All Consumer data will be stored locally, using industry standard (CCR) and native file formats (JPEG).

11 OpenPHI Platform Browser-based Consumer UI All Consumer data will be stored locally, using industry standard (CCR) and native file formats (JPEG). Server features running locally Remote storage; web hosting HealthAlbum Virtual Appliance ( VA ) runs inside the free VMware Player. Offering a secure, preconfigured package: no changes to host PC. Aggregate reference data Health Librarian Server will assist Consumers to establish point-topoint connection to provider's EMRs to extract Consumer's health records. External datasources: free; validated; updated HealthBriefcase provides interface for EMR vendors to output Consumer's health data into a HealthAlbum file (billing, medication reconciliation, etc.).

Offering a secure, preconfigured package: no changes to host PC.

12 HealthAlbum CRM: Consumer Health HealthAlbum flips Customer Relationship Management (CRM): CRM for Consumers to: manage customers manage providers store proposals store health records calls, meeting calendar appointments calendar tracks bugs, defects track illness, treatment compile knowledge set summarize literature archive s, faxes archive s, faxes analyze sales trends analyze health trends role-based access need-to-know access Business Dashboard Health Dashboard

bugs, defects track illness, treatment compile knowledge set summarize literature archive e-mails, faxes archive

13 Prescription usage listing Manage, store all documents Global search function across Consumer data Multi user system, role-based access control mechanisms. Track illnesses, treatment plans for each family member Easy access to all functionality Review guidelines, Evidence Based Med. Manage providers (physicians, clinics, hospitals, specialists) Manage open bills, reimbursements, claims, deductibles

Track illnesses, treatment plans for each family member Easy access to all functionality Review

HealthAlbum Specs Virtual Appliance ( VA ): software container holds an operating system (OS) with no modification to PC VA holds complete server environment web browser

14 HealthAlbum Specs Virtual Appliance ( VA ): software container holds an operating system (OS) with no modification to PC VA holds complete server environment web browser interface Consumer data is also stored locally runs on older PCs multiple languages Benefits: total consumer control high security, privacy portable, persistent improve health, healing

interface Consumer data is also stored locally runs on older PCs multiple languages

15 HealthAlbum vs. Other PHR Offerings Consumer data ownership Consumer controls access, usage Longitudinal Government (Veterans Adm.) Provider (Hospital) Employer (Dossia) RHIOs Limited Limited Limited Hosting service provider has Consumer trust. Guarantees no secondary data usage w/o opt in Designed for use while protecting Consumer's anonymity. Consumer controls where data is stored. How are the costs of the hosting service paid for? Can Consumer move data to another hosting option? Anonymous usage? (Consumer does T need to set up an account, and no need to log in.) Software's source code freely available under GPL for inspection, security audit? Software's source code available under GPL for modifications, improvements, customizations? Is Consumer data stored in industry-standard formats? Private, Webbased PHR Mostly HealthAlbum Insurance Company Mostly. Consumers. Consumers. Consumers. Consumers change providers change move city to city, change ins. cos. as needed. employers often. state to state. often. Some Limited None Limited Questionable Varies Taxes. Fees; revenue from data sales. Unknown. Fees; ads; revenue from data sales. Unknown. Fees; ads; revenue from data sales. No cost (your own PC) Unknown. Maybe. Maybe... Maybe. Maybe. Proprietary EMRs. Unknown.. Proprietary EMRs.. Maybe.

16 Why EMR <=> PHR? Ride Wave. Providers' Obligations: EMR Vendors' Must: a.) HIPAA Compliance a.) Customers' Looking for lower/no Vendor Lock b.) Medication Reconciliation b.) CCHIT Certification c.) Liability Reduction

17 JCAHO Medication Reconciliation "Reconciliation is the JCAHO's National Patient process of comparing Safety Goals for 2007, what medication the which includes #08a: patient is taking at the time of admission or "The complete list of entry to a new setting or medications is also level of care, with what provided to the patient the organization is on discharge from the providing (admission or facility." new medication orders) to avoid errors such as Safety/NationalPatientSafetyGoals/0 conflicts or 7_npsg_facts.htm unintentional omissions."

care, with what provided to the patient the organization is on discharge from the providing (admission or facility.

18 Liability Reduction HealthAlbum Usage: Benefits to hospital: provide electronic copy leave Consumer with a of all data collected positive feeling about during treatment / stay the care they received data visibility reduces higher transparency => anxiety, doubts reduced liability risks greatly facilitate follow reduce paperwork, up treatment at same, errors transferring to or any other provider other provider(s) Consumer is provided Consumer in charge of with tools, knowledge own health: improve for self-care outcomes, lower costs

reduced liability risks greatly facilitate follow reduce paperwork, up treatment at same, errors transferring to or any other

19 CCHIT Cert. for EMR Vendors CCHIT Ambulatory Examples might include the Functionality Criteria 07 continuity of care record or the CDA. This requirement does not Item 22: specify a particular format The system shall although many vendors provide templates for will choose to use the displaying medical harmonized summary data in a CCR/CDA/CRS once structured format available.

20 DEMO Credits: * Nancy Anthracite (VistA install instructions) * Kevin Toppenberg (XML export utility)

21 More Information José C. Lacal Chief Vision Officer Health Informatics +1 (954)

22 HealthLibrarian Search, indexing server to access 100s of peerreviewed, health-related databases, publications. Provides Consumers with accurate, and contextrelevant quality data. External Datasources: Guidelines Clearinghouse ClinicalTrials.gov more (100s) soon

HealthBriefcase EMR outputs Consumer's data to portable media (CD/DVD, USB drive) Consumer will load media into HealthAlbum at home to centralize data.

23 HealthBriefcase EMR outputs Consumer's data to portable media (CD/DVD, USB drive) Consumer will load media into HealthAlbum at home to centralize data. Value to EMR vendors: Benefits to providers: Help clients address Consumer's health medication data requests (HIPAA) reconciliation Input Consumer's data liability reduction into EMR, digitally improve Consumer satisfaction and loyalty

Integration for your Health Information System

Integration for your Health Information System Achieve comprehensive healthcare IT integration that leverages your existing IT investments and helps you meet the growing demands of Meaningful Use, HIE,

VistA and Personal Health Records

What type of diseases are consumers pushing to have?

What type of services have students of medical economics long realized that consumers demand?

What do faxes archive?