Healthy Living The Potential Of Personal Wellness Records (Phrs) - Purpose Ane Of 3

I've been involved late inwards an interesting virtual news (at this link on LinkedIn) that focuses on personal wellness records (PHRs). This begins a multi-post thread almost key number concerning PHRs that we've been examining.

1. Quite a few comments referred to the require for PHRs to convey existent value for the patient (or a loved one) that render value add together by:

• Providing information collection, analysis, feedback , instruction, follow-up care, decision-support tools, in addition to patient-provider communications (e.g., minute chat, recorded voice, email/message, etc.) that:
  
  • Help individuals in addition to their loved ones bargain efficiently in addition to effectively alongside their personal problems, including medical conditions, physical hurting in addition to psychosocial issues inwards guild to meliorate a patient/consumer's wellness status (outcomes), relieve him/her coin & time, in addition to cutting downwardly on medical errors, omissions in addition to unnecessary or ineffective treatments
  • Supply clinical information consist alongside Continuity of Care Documents/Records (e.g., diagnoses, medication lists/medication reconciliation data, allergies, occupation lists etc.
  • Focus on prevention in addition to self-maintenance (i.e., wellness) for fifty-fifty good for y'all people yesteryear including personally managed custom health/wellness programs, targeted incentives, wellness education, indicate of attention updating in addition to peril analysis, compliance in addition to adherence motivations, in addition to assistance inwards dealing alongside other personally (dis)stressful problems
  • Create empowerment in addition to engaging sense for one's wellness management
  • Enable baby-boomer to assist their aging parents in addition to children who are inwards college through the healthcare procedure every bit needed.
• Using social media to connect people in addition to promote digital collaboration alongside their entire attention squad (primary, specialists, nurses, mental health, holistic med) in addition to personal back upwards network (friends, family, in addition to those that are like to them/social network) inwards guild to nurture support/encouragement in addition to to develop
• Assisting alongside appointment grooming & scheduling, pharmacy, in addition to insurance claims processes
• Being interactional in addition to slowly in addition to convenient to usage (so uncomplicated to usage "a caveman could exercise it").

2. PHRs must endure flexible in addition to evolving, connect/integrated alongside EHRs/EMRs, in addition to conform whatever relevant standards by:

• Being customizable in addition to modular in addition to used on an "agile" platform that enables it to connect alongside most other applications
• Automatically sharing information alongside providers' EHRs (i.e., PHR-EHR integration):
  
  • One possible solution is providing database synchronization where at that topographic point is a large fundamental database on the server side (e.g., an HIE) in addition to a large number of pocket-size databases each residing on a device; the fundamental database contains information for all the devices land each device's local database entirely contains the device's private information in addition to around shared information
  • Another is having the PHR comprise actual information or pointers to that information that the patient could either mitt to a provider on a flash drive, deliver via an e-mail attachment or URL, or download straight into the provider's EHR from a secure, authenticated site; the PHR could hence larn the individual's HIE
  • And the occupation volition proceed every bit long every bit EHR companies are however edifice silos—no ane has stepped frontwards to exercise a really interoperable network in addition to each continues to construct its respective silo in addition to wants command of the patient data.
  • Able to usage HL7 in addition to all other information commutation standards.

3. PHRs information must endure controlled yesteryear the patient: The patient should endure able to command what types of information croak to which source; this should endure automated hence that entirely the entirely portions shared are those required for the appropriate degree of the transaction alongside patient inwards command [note that this is a disputed point]

4. PHRs must convey provider tie-in:

• PHR adoption has to endure driven from the provider side or nosotros don't convey consummate solution; nosotros require to render for a surroundings that allows for that interaction in addition to communication because patients exercise non convey truthful access to their ain medical information
• Certain information inwards a PHR must endure really useful to the provider (clinician/practitioner), e.g., showing the longitudinal tendency is of import
• Should non interfere alongside providers' workflows in addition to endure minimally intrusive

5. PHRs require payer tie-in:

• Scalability to these solutions needs to come upwards from payers support; enrollment inwards insured programme would easily back upwards the informational requirements of an initial PHR.
• Most payers offering tethered PHR's, which are non actually PHR's exactly histories of claim information
• PHR's are a hard value-added service for a wellness information technology vendor to curlicue out because they are high peril alongside picayune to know revenue generation, hence payers could fund their evolution in addition to deployment [note that this is a disputed point]

There were also several mentions of "data silos" inwards this discussion. I noted that on around other LinkedIn news (at this link), which includes a link to a uncomplicated in addition to low-cost fashion to cross the silos.

I discussed why I convey a occupation alongside creating monolithic centralized databases that comprise individually identifiable patient wellness information obtained yesteryear combining information from disparate local databases/repositories (silos). I argued that wellness information exchanges (HIEs) should entirely comprise (a) pointers to the silos where the information are stored, (b) aggregated deidentified information for biosurveillance in addition to question purposes and/or (c) identifiable information stored inwards private encrypted information files.

I agreed that PHRs should comprise information automatically retrieved from providers' EHRs, in addition to the EHRs should comprise information automatically retrieved from patient's PHRs.

I asserted that the patient should decide the information sets that tin endure shared betwixt the EHRs in addition to betwixt the EHRs in addition to PHR. These authorizations would endure contained inwards a Trusted Partner Agreement (TPA) created when the patient in addition to PCP offset meet, in addition to would endure updated every bit necessary.

In a pub/sub node-to-node (app to app) "forward in addition to store" communications environment, the publishing nodes would automatically choose the information sets to endure exchanged alongside their subscribing nodes based on roles rules reflecting inwards the TPA's authorizations. This depression cost, uncomplicated solution would bargain alongside the concerns others raised.

I hence explained that I've been working on a really unlike type of PHR for several decades, which we're calling a personal wellness profile. It addresses most of the requirements we've been discussing for a useful PHR. See this link for a three-part post almost it.

Continued at this link.

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