Health Information Technology Improving Health and Health Care with PHRs and EHRs David W. Sayen Regional Administrator Centers for Medicare

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Health Information Technology Improving Health
and Health Care with PHRs and EHRsDavid W.
SayenRegional AdministratorCenters for Medicare
Medicaid Services (CMS)

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How do you store your health information?

• ?

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Do U.S. Households Track Personal Health
Information?

• Thirty percent of U.S. consumers said their
  households track personal health information
• Fifty five percent said their household does not
  track personal health information
• Fifteen percent said they did not know.1
• 1Source Forrester Research, North American
  Technographics Healthcare Online Survey 2008

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How do U.S. Households Track Personal Health
Information?

• Of the households that track personal health
  information
• Seventy six percent said that they use a
  paper-based record-keeping system
• Eleven percent use an internet-based service or
  program
• Thirteen percent use a personal computer
  program.1
• 1Source Forrester Research, North American
  Technographics Healthcare Online Survey 2008

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Why Track Personal Health Information?

• You should help manage your health and your
  health care.
• You can become empowered with information.
• Personal Health Records or PHRs can make your
  life easier by helping you track your medical
  history.
• PHRs help you store all of your information in
  one place.

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What is a Personal Health Record?

• A personal health record, or PHR, is a tool
  designed to help you track and manage your health
  care.
• It is a place to store a collection of
  information about your health or health care
  services such as doctor visits, hospitalizations,
  medications, medical conditions, and additional
  information about yourself that you choose to
  add.
• You can sort your information in different ways
  and print reports to share with your doctors and
  others.
• Most PHRs are internet based.

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What is a Personal Health Record?

• Sometimes PHRs only contain data entered by you,
  but it can also include information from other
  sources such as a health plans.
• Web-based PHRs are secure, password-protected
  sites that are accessible from anywhere all one
  needs is Internet access.
• Access to the PHR can be shared or restricted
  it is entirely up to the user.
• PHRs may help improve the quality of your health
  care by making it easier for you to find and
  share information. It might even help reduce
  duplicate tests.

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More Benefits of PHRs

• PHRs put you in control of your information. You
  can add information about your help that you feel
  is important and you can control who has access
  to it.
• PHRs are especially helpful for people with
  chronic conditions who take many medications and
  visit different doctors offices frequently.
  Access to the PHR can be shared or restricted
  it is entirely up to the user.
• PHRs can help in a medical emergency by enabling
  health care providers to get information about
  you.
• PHRs can give drug interaction and drug recall
  information and provide links to trusted medical
  sites to help keep you up-to-date.

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PHRs vs. EHRs

• A PHR is controlled by the consumer
  (administrative data).
• An electronic health record (EHR) is owned by and
  under the control of the provider (physician,
  hospital, health center) (clinical data).

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MyMedicare.gov

• MyMedicare.gov is not a PHR.
• View claims.
• View eligibility, entitlement, and preventive
  services information.
• View enrollment information.
• Beneficiaries cannot add information.

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MyMedicare.gov vs. PHRs

• A PHR is different than MyMedicare.gov because a
  PHR has much more functionality and is owned by
  the user.
• MyMedicare.gov is owned by Medicare and can show
  claims. You can not add other information to
  MyMedicare.gov and you cannot share it with
  others.
• A PHR can allow the user to track data over a
  long time, collect and sort additional
  information, track health activities and print
  reports.

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Information for People with Medicare

• Medicare does not currently offer PHRs.
• Medicare pilots with PHRs
• PHR controlled by the beneficiary
• Medicare data used to populate PHR (Part A and
  B)
• Additional information can be added by the
  beneficiary
• Information can be sorted and viewed in different
  ways.

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Functions of Many PHRs

• Medication management (esp. refills) plus the
  ability to track prescriptions and over the
  counter medications.
• Links to educational information.
• Tracking lab results.
• Managing out of pocket expenses.
• scheduling appointments with your doctor.
• secure messaging with your doctor.

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My Personal Health Record South Carolina (MyPHRSC)

• Medicare Fee-for-Service Pilot.
• Testing outreach to, and adoption of PHRs by FFS
  Medicare beneficiaries
• Comprehensive outreach plan
• Working with CMS Regional Office and local
  partners for support.
• Initial target - 100k beneficiaries in South
  Carolina.
• Use existing commercial PHR HealthTrio.
• Medicare contractor provides claims data
  Palmetto.

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MyPHRSC

• Collaboration with the Department of Defense
  (DOD)
• Working with the DoD to add additional data for
  65 TRICARE and TRICARE For Life (TFL)
  beneficiaries residing in South Carolina who
  participate in the MyPHRSC pilot
• Those targeted are Medicare beneficiaries first
  and have TRICARE as their secondary payer
• DoD wants to make medical information such as
  active meds, allergies, and other information
  contained in their medical IT systems available
  to their TFL participants to supplement the
  Medicare information in MyPHRSC.

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Medicare PHR Choice

• Helping beneficiaries have access to their health
  information online, anytime.

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Medicare PHR Choice

• Pilot program for 2009 in Arizona and Utah.
• Medicare is partnering with four private PHR
  companies to encourage PHR use designed to give
  people choice of tools.
• Medicare will auto-populate up to 2 years of Part
  A Part B claims into a PHR and continue to add
  new claims as they are available in 2009.
• Medicare can not access any information in an
  individuals PHR.
• Individuals keep claims data and PHR after pilot
  is over.

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Who Can Participate in Medicare PHR Choice?

• Only people with Original Medicare with a primary
  residence in Arizona or Utah can participate in
  the pilot.
• Individuals need to select one of the
  participating companies in the Medicare PHR
  Choice program to have their claims automatically
  added to their PHR.
• Snowbirds can use a PHR have records when away
  from home.

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Medicare PHR Choice

• Pilot January 13 December 31, 2009 (may be
  extended).
• Go to http//www.medicare.gov/phr - Homepage.
• Select Medicare PHR Choice green button.
• Compare the available PHR tools link outside of
  Medicare.gov to go to their sites and view demos,
  etc.
• Sign-up for a PHR tool on the company site you
  selected.
• Once signed-up access their PHR through the
  companys website.

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Participating Vendors


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Medicare PHR Choice
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Medicare PHR Choice

• People with Medicare should have their Medicare
  card with them when they sign-up for their PHR.
• Once signed-up for their PHR, the company will
  link the individual to Noridian Administrative
  Services.
• The individual will then provide key
  information/Medicare number and agree to allow
  Medicare to input their claims data into their
  PHR automatically. Noridian will verify the
  information before claims are transferred into a
  PHR.
• The data is not shared with anyone else and it is
  not kept or stored by the PHR. The claims are the
  property of the individual, just like all other
  information in their PHR.
• If someone decides to delete their account, the
  claims data is deleted with their PHR file.
  Claims cannot be transferred to another PHR.

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Comparing PHR Companies

• Encourage beneficiaries to explore all of the
  vendors Web sites.
• The individuals comfort with navigating a site
  should be a key consideration in selecting a PHR.
  
• All offer a Free PHR, however some companies
  offer extra services and features for a fee.
• Some PHR companies are discounting their fee
  during the pilot check with company to see if
  there will be a cost to maintain the PHR after
  the pilot is over.
• See the compare chart for a listing of basic and
  specialized features and costs.

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Comparing PHR Companies

• Some things to consider when selecting a PHR
  include
• Can the PHR import my claims or medical
  information from my health plan and/or doctors?
• What kinds of features does the PHR offer, such
  as the ability to print a list of my medications
  or conditions?
• Can I give permission to my doctors or family
  members to look at my PHR for me?
• Does the PHR offer links to other websites that
  provide educational information about health
  issues?
• Is there a monthly or annual fee to use the PHR?
  Is there a cost for extra features?
• What will happen to my information if the company
  that provides the PHR goes out of business or
  becomes part of another company?
• What are the PHR's privacy and security policies?
  

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Security Privacy

• PHR accounts have similar security policies and
  standards to other online functions, like banking
  and shopping.
• Individuals have a unique ID and password for
  their PHR account.
• Each PHR company in the Medicare PHR Choice had
  to include security and privacy policies to keep
  individuals information safe.
• Each PHR company uses a different security and
  policy system it is important to look at them
  before selecting and signing up for a PHR.
• Medicare will not have access to any individuals
  information in their PHR.

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Stay Informed- Region IX Stakeholder Call

• Every 3rd Thursday of the month, 2-3pm PST
• Next call, July 16th, 2009 at 2 PM PST.
• Toll Free 1-888-452-0273
• Pass Code Stakeholder Call
• Leader David Saÿen
• Register for CMS Region IX Stakeholder listserv
  for notification and details about calls, please
  contact nicole.lockey_at_cms.hhs.gov

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