"PHR in Your Pocket" Making the Citizen a Partner in Own Health Care. Rachelle Kaye, PhD May 2014

"PHR in Your Pocket" Making the Citizen a Partner in Own Health Care. Rachelle Kaye, PhD May 2014

Initial Steps Prerequisites for Partnership 1. Clinicians willing to partner 2. Citizens willing to share responsibility 3. Commitment to Integrated Care 4. ehealth Infrastructure Electronic Medical Records- Transparency of Medical Records to clinicians and citizens Computerization of relevant clinical data/information Easy access to the information 5. Support of the Powers that Be

Every transaction with the patient is computerized Every provider uses the Maccabi Electronic Medical Record Maccabi EMR includes the whole patient record E-Laboratory E- Prescription E- Consultation Telemedicine Integrated Care Through ICT in Maccabi Healthcare Services Alerts and Reminders Physician Portal on web and mobile Patient Website on web and mobile

The Maccabi Information System 5000 physicians 31 Imaging Centers 300 Lab Collection Points 36 Physiotherapy Clinics Central Laboratory 95 Nurse Stations 140 Branches 32 Hospitals 700 Pharmacies

ICT at the physician s service Billing & Claims

Embedded guidelines Drug interaction warnings Prescription prioritization recommendations Mandatory data fields (BP, smoking) Recommended laboratory test alerts Diagnosis-related lab test panels Organizational alerts Rules engine based alerts

Empowerment of the Patient (PHR)

PHR Personal Health Record Maccabi On-Line Personal and secured web site for Maccabi members Includes medical and administrative data Our member can: View personal data from Maccabi s systems - mainly his medical record Do Online administrative actions Enter his/her own data

1.600.000 1.400.000 1.200.000 Number of Subscribers to Maccabi Online 2003-2013 1.130.183 1.252.573 1.384.351 1.462.465 1.000.000 961.577 800.000 677.923 815.272 600.000 561.491 400.000 430.079 251.716 200.000 164.669 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 * 69.4 72.7

Access to Medical Information E.K.G

Access to Calculators and Tools

תיק רפואי Medical Record Managing your online EMR תקציר תיק רפואי תקשורת עם הרופא Personal medical recommendations זימון תור פעולות ומידע מינהלי בתי מרקחת המלצות Summary אישיות הרופאים והמטפלים שלי Personal recommendations תוצאות בדיקות נתונים רפואיים אישיים Test results חיסונים Personal medical data מסמכים ורשומות Mental רפואיות health טיפולי בריאות הנפש דף for the מידע למבוטח Information diabetics סוכרתי Like me כמוני Personal Reminders to your email or mobile Join Here Clinical Support Alerts Following are specific recommendations for you according to your age, sex and health status and additional information in our system. Based on this information you can know what you need to do and what you have not done to promote your health Occult Blood in stool Hemoglobin AIC Lab tests This test is recommended annually over age 50. You have not done this test in over a year. We invite you to come to the lab. For patients with diabetes, its very important to measure the level of hemoglobin AIC in the blood annually. Please contact your physician for referral to the test Vaccinations Pneumovax This is a vaccination for preventing pneumonia for people 65+ please go to the nurses clinic in your branch to get vaccinated

Vaccinations Self-Follow-up

Virtual Visit- Doctor- Patient Subjects for virtual visit: Request for Medications renewal Referrals for Lab tests Health Information sheets Different medical certificates

Hello Rachelle Kaye I.D 11497484 Request for Prescription/ referral Print Prescription Request for Prescription Dr. John Smith Choose Doctor Requests Telephone

And Now It s In Your Pocket

Doctor Portal - Patient EMR Main App enabled doctors to view patients records and respond to immediate issues Launched: December 2011 Platforms:iPhone, Android Patient test results Medication Visits Medical Knowledgebase

Mobile Patients Portal

Referring doctor Date Lab Results

Medications List

Disease management Send Data to e-mail

Alerts and Reminders

Service Directory Find a service Physicians Urgent Care Centers Pharmacy Branch Labs and Clinics Maccabi N`atural Maccabi First look

LOCATE Your SERVICE - GPS

Create A New Request Requests to doctor Member;Israel israel ID 123456789 Dr. Leah Lorbin Requests to doctor Member;Israel israel ID 123456789 Dr. Leah Lorbin You can make a request only if you visited this doctor in the last year OK Create a new request Create a new request

Request Prescription Renewal cance l MY DRUGS ok New Request Member;Israel israel ID 123456789 Dr Ido Jacobs Family Physician Member;Israel israel ID 123456789 Prescription? Choose from your list of drugs Phone : Send request

Your request has been sent Requests to doctor Member;Israel israel ID 123456789 Dr. Leah Lorbin Your request has been sent successfully. Response within 5 days Close Close Create a new request

View of the Request With Response Requests to doctor Member;Israel israel ID 123456789 Response from Dr Gidi Lorben Dear Israel, Attached are the 3 prescriptions you requested. Sincerely, Dr. Gidi Lorben Prescription: Valid 13.5.13-13.6.13 Prescription Valid Prescription Not Valid My request Renew Request

Main Physicians Urgent Care Clinics Pharmacies Maccabi Branches Labs and diagnostic tests Protected accommodation and hospitalization Maccabi natural

Pregnancy Diary A unique application dedicated to Israeli pregnant women needs. Pregnancy scheduling Timeline Tests needs to be done through Pregnancy Explanations for each week Tests results Personal experience

Achievements 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Blood Pressure Diabetes Follow-up - 2012 Lipids HbA1c BMI µalbumin Fundus

Blood Pressure Screening

Real Time Information for Patient & Clinician Creates Partnership and Leads to Better Health