Exploring Challenges and Potentials of Exploring Challenges and Potentials of Personal HealthPersonal Health

Records in Diabetes Self-Management: Records in Diabetes Self-Management: ImplementationImplementation

and Initial Assessmentand Initial Assessment

Telemedicine journal and e-health 2007Telemedicine journal and e-health 2007

RACHEL HESS, CINDY L. BRYCE, SUZANNE RACHEL HESS, CINDY L. BRYCE, SUZANNE PAONE, GARY FISCHER, KATHLEEN M. M C PAONE, GARY FISCHER, KATHLEEN M. M C

TIGUE, ELLEN OLSHANSKY, SUSAN TIGUE, ELLEN OLSHANSKY, SUSAN ZICKMUND, KATHARINE FITZGERALD and ZICKMUND, KATHARINE FITZGERALD and

LINDA SIMINERIOLINDA SIMINERIO

IntroductionIntroduction Chronic Care Model (CCM)Chronic Care Model (CCM)

Clinical information systems provide disease-Clinical information systems provide disease-specific patient registries.specific patient registries.

Computer-based decision support for practitioners.Computer-based decision support for practitioners. Development of healthcare system and community Development of healthcare system and community

change to facilitate longitudinal care.change to facilitate longitudinal care. Programs to support patients’ effective self-Programs to support patients’ effective self-

management.management.

Institute of Medicine (IOM): Institute of Medicine (IOM):

EMR—EMR— The practitioner-maintained portionThe practitioner-maintained portion Personal Health Record (PHR)Personal Health Record (PHR)

UPMC Health-TrakUPMC Health-Trak

MATERIALS AND MATERIALS AND METHODSMETHODS

Integration of secure patient messaging into Integration of secure patient messaging into the workflow of practice.the workflow of practice.

““phone tag” could go on, when office tries to phone tag” could go on, when office tries to call back.call back.

The risk of inaccurate transcription.The risk of inaccurate transcription.

Convenient for the patient and the physician.Convenient for the patient and the physician.

ResultsResults

Patient reactionsPatient reactions Provider or diabetes educator could adjust Provider or diabetes educator could adjust

medications during the interval between office visits.medications during the interval between office visits.

Receive appointment reminders and test results Receive appointment reminders and test results electronically suited their busy schedules.electronically suited their busy schedules.

Gave patient the ability to schedule and cancel Gave patient the ability to schedule and cancel appointments at their convenience.appointments at their convenience.

Missing lab results, inaccurate information, and slow Missing lab results, inaccurate information, and slow responses from the physician and/or nurse.responses from the physician and/or nurse.

Expectations of being able to contact all of their Expectations of being able to contact all of their physicians, not just their primary care physician.physicians, not just their primary care physician.

DISCUSSIONDISCUSSION The ability to view portions of the EMR, help to The ability to view portions of the EMR, help to

ensure that patients are aware of important aspects ensure that patients are aware of important aspects of their own diseases.of their own diseases.

Eliminating the need to “catch the doctor”.Eliminating the need to “catch the doctor”.

Requests for medication renewals and physician Requests for medication renewals and physician referrals can be structured so that referrals can be structured so that patients provide patients provide all necessary information to process the requestsall necessary information to process the requests..

Users less frequently discussed educational Users less frequently discussed educational resources, suggesting that simply placing resources, suggesting that simply placing resources within an environment is inadequate to resources within an environment is inadequate to stimulate patient use.stimulate patient use.