myhealthbits: personal health record bambang parmanto health information management department,...
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MyHealthBits: Personal Health Record
Bambang Parmanto
Health Information Management Department, University of Pittsburgh
Background: Personal Health Record
EHR and PHR
EHR is provider centric: owned by doctor office, hospital, or an integrated system (e.g UPMC)
One patient may have several EHR under control of various orgs (scattered). No one EHR has all the patient info
PHR is patient centric. PHR: EHR from providers + personally generated
info (daily symptoms, over the counter meds, exercise, diets, health monitoring devices)
PHR + Disease & treatment info = active participant of their own healthcare
PHR and Consumer Empowerment
Benefits: improved patient safety, better health info availability
Consumer use health info for decision making
Individuals more interested in maintaining their own health record
Patients as “Co-Pilot” in their care
Perceived Benefits by Patients (Tang, 2006)
Timely access to lab test and medical records make patients feel that they have a better picture and more control of their health
Results in empowerment and transformation: 1/5 of participants changed their behavior as a result of access to PHR. …. “Because I’ve had ready access to this information, I was
able to tailor a diet specifically to adjust my blood lipids… I saw the improved test results two weeks ago….”
More connected to providers. Change the dynamic of the care Patients do not abuse the privilege. 92% doctors felt that
patients use the service at the expected level
Optimal Characteristics of PHR (AMIA White Paper)
1st: Lifelong and comprehensive 2nd: Accessible from anyplace anytime 3rd: Must provide health management tool
that helps patients understand the record, along with recommendations to improve their health
4th: Private and secure 5th: Patients control the access and how the
info is used.
MyHealthBits
Research Agenda: MyHealthBits Focus
Lifelong/longitudinal: Health record for everything: user interface, record
management, etc. Design schema that meets standard, but meets
user’s needs Personal
Managing Personally-generated data Helping users manage their own personal health
Communication between patients & providers Email with Provider Videoconferencing with Provider (ConferenceXP)
Privacy and patient control: What to share with whom
MyHealthBits and MyLifeBits
Cannot use the MyLifeBits platform Records/Contents are very different, MLB source
code is not available Has to build from the ground up: Platform:
MHB is client-server, MLB is local stand-alone Use as many ideas from MyLifeBits
Storage/record management Web & Email capture Database: stored procedure
• Toward an object oriented approach View of the data: time, type
Personal Health Records of Everything
MyLifeBits: Records of Everything
Record View
Record View: MyLifeBits
Progress
Longitudinal/LifeTime Health Record Developing database schema using CCR standard Integrating multimodal data sets in the database Presenting multimodal data sets into a lifeline
Personal Capturing and presenting/managing web pages Capturing wearable device: pedometer Personal health record management (mostly static)
Communication Capturing videoconferencing (using ConferenceXP) Capturing and presenting/managing email
Health Records
Personal Information:Personal & Demographic InfoEmergency Contact
Health Condition:Major Illness & Problem ListsMedication, AllergiesFamily HistoryAdvanced Directive, Care Plan
Health History TimeLine:ImmunizationLab Tests & ImagingProcedures (Hospitalization & Surgery)Provider VisitsPersonal Health monitored data (eg., BP, glucose, peak flow )
Healthcare Provider & InsuranceProviders, Insurances
MyHealthBits
Defining Timeframe
Selecting Health Record Type
Preview
Preview
Preview: web page
Grid View
PHR Schema
Next Step & Challenges
Longitudinal: Tuning the schema: striking a balance between
standard & ease of personal use From “document-based” to “health event-based”: I
have CT-scan -> what is the diagnosis? Vice versa Richer records
Personal “intelligent” record detection/watcher (recognizing
that the file is MRI or an email, etc. Capturing more wearable devices Presenting data from wearable devices: data points,
documents?? Communication
Managing communication records (email, videoconf)