Wednesday, January 18, 2012

Some More Evidence And Commentary Regarding PHRs - Some Varying Views For You To Consider and A Very Interesting Site to Visit!

First we have this:

Why Personal Health Records Have Flopped

It's not a security, privacy, or data-sharing problem. It's a patient problem.
By Paul Cerrato,  InformationWeek
January 13, 2012
What's holding people back from signing up for a personal health record? According to Colin Evans, former CEO of the PHR provider Dossia, it's the unwillingness of healthcare providers to give them control over their medical data.
I couldn't disagree more.
The main reason the public doesn't sign up for PHRs en mass is they don't really care that much about their health. Yes, concerns about security and privacy and the reluctance of providers to share patient information slow things down, but at its core this is about apathy.
Just look at the statistics. Despite the push by medical and technology industry stakeholders over the years, only about 10% of Americans now use an electronic PHR. And let's not forget the recent demise of Google Health, the search giant's attempt to get the public interested in PHRs.
As I've said before, most Americans care more about their cars than their health. They know more about automotive specs than they do about physiological specs. Similarly, most people want to see a doctor only when something breaks down, and then they expect a pill or procedure to make things right, just as they expect their car mechanic to fix their cars. Healthcare for most Americans is about having someone else "make it better," not about personal responsibility.
More here
and second a rather more hopeful tone is struck here.

Is 2012 The Year Of Online Patients?

Meaningful Use programs, healthcare reform, and the public's love of mobile devices could add up to patients finally getting fully involved in their own care.
By Marianne Kolbasuk McGee,  InformationWeek
January 12, 2012
Sticking with New Year's resolutions is still top of mind for many folks. No doubt many are looking to the new smartphones, iPads, and health-related apps that Santa delivered to help fulfill those resolutions. So could 2012 be the year of tech-enabled patient engagement?
A New Year's resolution may only be the tip of the iceberg. Meaningful use and accountable care organizations will encourage patient engagement, according to Patti Brennan, a professor of nursing and engineering at the University of Wisconsin-Madison and national program director of Project HealthDesign.
The program, launched several years ago and funded by the Robert Wood Johnson Foundation, explores ways to improve personal health records by capturing and integrating patient recorded data.
"With MU and ACOs, it begins to really matter what happens to patients when they're not there" in the clinical setting, said Brennan in an interview with InformationWeek Healthcare.
First, the HITECH Act's $27 billion-plus Meaningful Use program has more clinicians rolling out systems that digitize patient data. Also, Stage 2 and Stage 3 are expected to require more electronic interaction between patients and clinicians, she said.
Meanwhile, more clinicians are planning to participate in accountable care organizations, whose payment models aim to reward healthcare providers for more coordinated care and improved patient outcomes.
In order for these organizations to work, doctors will have to convince patients to get more involved in their own healthcare--including using their own data to keep better tabs on their illnesses. In fact, payments tied to better patient outcomes--helped by smarter use of patient data-- is a big driver for more healthcare providers to participate in patient engagement initiatives, Brennan said.
Yet, with so much on doctors' plates as it is—"most doctors don't want a tsunami of new data" added to EHR and other systems from their patients' home health monitoring or wellness devices, said Brennan. That's especially true since most of this data doesn't warrant emergency care.
However, when there is an issue that requires immediate attention, Project HealthDesign teams have found that patients' monitoring data can be successfully sent to or shared with other clinicians, such as triage nurses or case managers, who can often help facilitate earlier intervention, or give feedback to patients without overwhelming doctors.
Patients who do have chronic conditions "want to have an easy way of monitoring themselves without overdoing it," because when they are tracking too many things or too frequently, "they end up giving up the monitoring within a few weeks or months," said Brennan.
Lots more here:
This site is a very interesting goldmine of ideas that might contribute to a ‘reboot’ of the idea of the PHR. Of course if NEHTA and DoHA are following this work they are - as usual - keeping it secret!
Just why doesn’t NEHTA have a news resource to keep the public and interested professionals across just what is happening overseas in e-Health. (Surely they can’t be happy to leave it to others?) Could it be they are just so insular they actually don’t know what is going on or is it that they don’t see they have a role in information provision and education beyond glittery PR brochures that are as content free as possible.
Whatever the reason - here is the link:
Well worth a browse to see how others are thinking about making the PHR useful, what groups would most benefit and so on.
Someone should ask when we will have a mobile device enabled PCEHR!
David.

2 comments:

EA said...

Cerrato's These are societal problems that require massive cultural shifts is dead right.
One factor underlying Cerrato's observation could be the rising role of private health insurance. It could be said that those citizens who require more health care, or who care more about their health, are paying $5 extra per day for PHI. That, alone, may push people further into the belief that "someone else" is looking after their own personal health. So, what are we hearing from the PHI sector about PCEHR? Anyone?
The other issue that underlines Cerrato's conclusion is the role of personal health records of the old-fashioned kind. What proportion of GPs are required to pore over pages of hand-written personal accounts? If that number was greater than 30, there may have been a good chance of a fair-dinkum political driver for PCEHR.
Logical conclusions aside, it may well be that a majority of today's growing net-savvy crowd will expect to look up their current state of health on their mobile device without actual input from themselves.

Anonymous said...

As you said "it may well be that a majority of today's growing net-savvy crowd will expect to look up their current state of health on their mobile device without actual input from themselves."

Well, IF NEHTA understood that it would embrace eScripts as its highest priority because that is what most people seem to want most - a straightforward way to manage their medications. I can't tell you how often I am asked for a list of one of my families current medications, what they are taking, for how long etc. My father takes 10 different medications every day and mum takes 5 and my husband takes blood pressure, cholesterol and insulin tablets. And guess who is the bunny that has to keep an eye on them all, not to mention my children. They seem to depend on me to make sure they are taking their pills. As a nurse perhaps I'm trained to hold their hands but it would be so good to have it all available electronically.