Connecting Patients, Providers, and Payers

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Connecting Patients, Providers, and Payers

• John D. Halamka MD
• CIO, Harvard Medical School

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Agenda

• Current state of electronic health records and
  e-Prescribing in the US
• Overview of Interoperability
• Personal Health Records

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National Efforts

• AHIC and National eHealth Collaborative (NeHC)
• Health Information Technology Standards Panel
• Certification Commission on Health Information
  Technology
• Nationwide Health Information Network

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AHIC Priorities and Use Case Roadmap
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Current Use in the US

• Depending on the definition of an EHR, adoption
  varies from 2 to 20
• Medicare Incentives are driving e-Prescribing
• Pay for Performance is likely to require EHRs
  over the next 4 years
• Regulations now enable hospitals to subsidize 85
  of implementation costs

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Electronic Health Records for the Boston Community

• The Motivation
• The Applications
• The Infrastructure
• The Services
• The Economics

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Best Practices

• Documentation of Problems, Medications,
  Allergies, Visits, Notes, Reports, Labs,
  Screening Sheets
• e-Prescribing
• Referral Workflow
• Order Sets with full decision support
• Alerts/Reminders
• Community Data Sharing
• Personal Health Records

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Clinical Systems Plan
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The MA-Share Appliance

• Built on a common messaging gateway framework
• Placed on the network of each participating
  institution

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Approach to Data Sharing

• Doctor to Doctor
• Doctor to Hospital/Hospital to Doctor
• Community to Community
• Quality Warehouse
• NEHEN
• Personal Health Records

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Personal Health Records

• Google Health
• Microsoft Health Vault
• Dossia/Indivo

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PatientSite

• Patientsite over the past 7 years
• 2.5 million transactions and 40,000 monthly
  patient users
• All the worries about provider and patient
  information overload have not occurred

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Patient Access to RecordS

• What should they see?
• When should they see it?
• Who else should have access?
• How should we present it?

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Educational Partners

• PreOp Patient Education
• UpToDate Provider Edition
• UpToDate Patient Edition
• Medical Dictionary
• Lab Test Online

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Messaging Volume

• Clinical messages 27.8
• Prescription renewals 3.1
• Referrals 2.1
• Appointment requests 2.6

monthly volume per 100 patients
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Patients

• 57 female
• Median age 43
• 4 over 70 years old

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Patient Experience

• Secure Messaging with Provider
• Access to Medical Records
• Convenience
• Request Appointments
• Medication Refills
• Referrals to Specialists
• Review Bills Online
• Education
• Disease specific content by experts at CareGroup
• Links to medication information
• Personalized drug interaction information

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Questions?

• jhalamka_at_caregroup.harvard.edu
• http//geekdoctor.blogspot.com