Personal Health Records Systems of the Future: A Bold Vision for people, Wisconsin and the country

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Personal Health Records Systems of the Future A
Bold Vision for people, Wisconsin and the country

• Patricia Flatley Brennan, RN, PhD
• National Program Director
• Project HealthDesign
• School of Nursing and College of Engineering
• University of Wisconsin-Madison

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Governors eHealth Action Plan 2006
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Health Information Exchange
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What do people need to do to be healthy?
Motivate Monitor Mentor Mend Manage!
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The many flavors of PHR c. 2007

• Institutional/IDN provider portal
• Individual provider portal
• Untethered USB, desktop, PDA
• Populated from claims data
• Population oriented
• Condition oriented
• Service oriented

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A sampler of PHRs.
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Tethered to provider EHR
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PatientSite CareGroup/Boston
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Tethered to pharmacy data
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Retail Pharmacy
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Populated from claims data
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Targeting specific conditions
From Cerner
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Emergency Response
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Beyond data management and transfer, what can a
PHR do to improve the health of the people of
Wisconsin?
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imagine...
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the dinner plate that knows what is on it
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Imagine that the dinner plate that knows what is
on it can

• weigh the food
• do a chemical analysis
• use an embedded chip to
• obtain nutritional information from an
  USDA database
• query your health goals recent intake
• flash green if youre OK or red if you must
  skip dessert!

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imagine...
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Clothing that knows where you are,
evaluates the quality of ambient air around
you ...stores coaching tools, medication, and
water! and had a sensor that vibrated in
anticipation of your need for your rescue
inhaler
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imagine...
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now imagine...
What an integrated view on people, their health
behaviors and health practices, and health
care, could do for patient care, public
health, and the well-being ofall citizens!
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What if there was a information pathway from the
point of care, anywhere!

• What if --
• All hospitals had such a plate and a patients
  nutritional status could be tracked exactly?
• A kid with peanut allergy had a lunch box with a
  sensor to alert her whenever a peanut-containing
  substance was entered?
• A band aid could call your cell phone to tell you
  if an infection was starting?

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Project HealthDesign Rethinking the power and
potentialof personal health records
Patti Brennan National Program DirectorProject
HealthDesign Gail Casper Deputy Director,
Project HealthDesign NPO Steve DownsProgram
OfficerRobert Wood Johnson Foundation Veenu
Aulakh California HealthCare Foundation
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Project HealthDesign

• Grantee teams
• Art Center College of Design
• Joslin Diabetes Center
• RTI, International
• University of California- San Francisco
• University of Colorado at Denver Health Science
  Center
• University of Massachusetts Medical School
• University of Rochester
• University of Washington
• Vanderbilt University

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Art Center College of Design
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Joslin Diabetes Center
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RTI, International
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University of California- San Francisco
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University of Colorado at Denver Health Science
Center
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University of Massachusetts Medical School
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University of Rochester
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University of Washington
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Vanderbilt University
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Discussion and Questions
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Why is Project HealthDesign unique?

• Cooperative design development of innovative
  applications
• Derives core functions as a byproduct of
  applications development
• Engages intended users early and often
• Confronts (and sometimes resolves) ethical, legal
  social issues

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What kinds of decisions do people need help with?

• Planning, course-setting decisions
• Treatment
• Initiate health promoting activities
• Choosing a strategy
• Process, course-directing decisions
• Interpreting symptoms
• Determining what to do

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What kinds of questions do people ask?

• Is this normal?
• Should I adjust my medication?
• Can I expect to feel like this for the next xxx
  days?
• Do I need to come in and see the doctor?

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• PHRs and RHIOs and HIEs
• Whats the intersection?

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PHRs, RHIOs and HIEs

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PHR, RHIOs and HIEs
Patient Patterns
Capture observations indaily life
Device performance
Relevant Rules
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RHIOs

• The blue line

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RHIOs

• The blue line

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HIE

• The blue line

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Teams, technical partners andtest beds
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Calendar
OBS
Medication
IDENTITY
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www.projecthealthdesign.org