Overview

2. Overview • What it is • How it works • How patients sign up • What happens next

3. What is thePersonal Health Record

4. Definitions • An electronic record of individually identifiable health information on an individual that can be drawn from multiple sources and that is managed, shared, and controlled by or primarily for the individual.

5. Definitions • Personal health record: an electronic application through which patients can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment. • Patient portal: an internet application that allows patients to access their electronic health records and permits two-way communication between patients and their healthcare providers.

6. Personal Health Record • Developed with the assistance of over 75 subject matter experts. • Funded through ARRA. • Designed to meet the requirements of: • Meaningful use • Privacy/HIPAA • Security • Patient Preferences

7. Meaningful Use & PHR Stage 3 – Increasing Electronic Synergies Stage 2 – Engage Patients, Families and More Stage 1 – Timely Access to Health Data

8. PHR Stage 1 MU Ready OPTIONAL Measure: Timely Access to Health Data PHR is Ready to Deliver: • View Medicines • View Lab Results • View Allergies • View Problem List • Blue Button Data Download Plus Administration & Security Necessary to enable Timely Access

9. Status • PHR application has been deployed nationally • Not functional until configured and patients are given access to their records • Dependent upon: • Completion of security testing • Functional Beta testing • Deployment will follow MPI

10. Sample Screenshots

11. Patient Views Medicines

12. Patient Views Allergies

13. Patient Views Labs

14. Patient Views Problems

15. “Blue-Button”

16. How does the PHR work?

17. Pieces of the PHR • Central PHR server (maintained by OIT) • Master Patient Index (MPI) • Local PHR server (at your site) • Administration application • RPMS • Web server • Patient’s internet browser

18. PHR Architecture

19. How does the patient sign up for the PHR?

20. Creating an Account • Create a PHR account online • Validate identity

21. Patient registration Patient query PHR PHR Registrar Servers are currently located at the BIA building in Albuquerque, maintained by IHS

22. Patient registration Patient query PHR Registrar Search MPI

23. Patient registration Patient query PHR Matches Registrar Search MPI

24. Patient registration Patient query PHR Validation Matches Registrar Search MPI

25. Patient uses PHR Logs in PHR Patient

26. Patient uses PHR Logs in PHR ID Patient Patient RPMS

27. Patient uses PHR Logs in PHR ID Patient Patient Data display RPMS Medications Allergies Problems Labs

28. Patient uses PHR Logs in PHR ID Patient Patient Data display RPMS Medications Allergies Problems Labs

29. PHR Roles • IHS Administrator • National Administrator • Area Administrator • Service Unit/Facility Administrator • Registrar

30. PHR Responsibilities • Patient Registration • Registrar • Amendments • Deleting Accounts • Breach Incidents • Resetting Passwords

31. Policies • Verify patient identity • Process patient application • find PHR account, find medical record, verify identity, then link • Unlinking patients

32. Orient Patient to PHR • Orientation materials available include: • Summary of PHR Features & Benefits • Demonstrations? • Handouts? • Online videos?

33. Reports • PHR creates user-selected ad-hoc reports • Privileges for Registrars & System Administrators • Reports Contain “Event” Information • Patient, registrar, administrator, PHR events

34. What are the next steps?

35. OIT Plans • Identify deployment team • Identify test sites • Identify development team • Address minor C&A issues • Review stage 2 Meaningful Use requirements • Determine next steps

36. Stage 2 Meaningful Use • View, Download, and Transmit • EPs: Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP. • EHs and CAHs: Provide patients the ability to view online, download, and transmit information about a hospital admission. • Target > 10% of patients

37. View, Download, Transmit • View – see on the screen • Download – export PHR information as a text file or send to a printer • Transmit – send a CDA to another health care provider

38. Internet Access • Exclusion: if >50% of homes in a county do not have 3Mbps internet access based on data from the FCC • www.broadbandmap.gov

39. PHR Data Fields • Patient Name. • Admit and discharge date and location. • Reason for hospitalization. • Care team including the attending of record as well as other providers of care. • Procedures performed during admission. • Current and historical problem list. • Current medication list and medication history. • Current medication allergy list and medication allergy history. • Vital signs at discharge. • Laboratory test results (available at time of discharge). • Summary of care record for transitions of care or referrals to another provider. • Care plan field(s), including goals and instructions. • Discharge instructions for patient, and • Demographics maintained by hospital (gender, race, ethnicity, date of birth, preferred language, smoking status). • Patient Accessible log • Accessibility

40. Secure Messaging • Use secure electronic messaging to communicate with patients on relevant health information. • Target > 5%

41. Open Source Options

42. Open Source Options

43. Open Source Options

44. How to prepare • Think about processes • Who will be responsible for administering the PHR (assign registration privileges) • Who will be responsible for registering patients • Where will registration take place • Patient registration? Medical Records? • What is the process going to be for registering patients?

45. Questions Chris Lamer (615) 669-2747 Chris.Lamer@ihs.gov