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| Glenn R. Galloway |
Demand for patients to manage their own health records is increasing. Over the next 10 years, as the most wired generation becomes consumers of health care services and aging baby boomers become more dependent on those services, the most wired hospitals will need to support personal health records (PHRs).
Both generations have either grown up with the Internet or learned to rely on it for everything from online banking to grocery shopping services. These same consumers are starting to manage their financial options for health care through health savings accounts. Finally, many work for employers that encourage them to take more responsibility for their health care costs. These consumers will expect and demand the same kind of accessible management of their health care.
Recent announcements of new personal health record portals being launched by successful technology and non-health care leaders alike demonstrate that PHRs are being taken seriously. Even well-known and successful consumer financial management software products are offering a personal health record.
What’s Here Now
We’ve all heard the vision of the PHR. Essentially, the PHR will manage and collect the consumer’s health information--whether it’s providing access to general health information, managing financial transactions, collecting up-to-date, relevant disease management information, sending patient-entered updates to the physician or providing reminders to patients and physicians.
Currently, PHRs are being offered through insurance providers, hospital information systems and stand-alone products. All have various advantages and disadvantages, but a common disadvantage is that the consumer must manually maintain most of the information. Unfortunately, there is no clear solution available today to overcome this obstacle.
In order to get ready for PHR demand, the most wired hospitals will need to develop a PHR strategy now. A long-range strategy must be adaptable to evolving PHR options that will be available to consumers. The starting point will be to incorporate objectives with an overall institutional strategy, since the PHR services offered may even end up being a competitive differentiator and cost-saving measure.
Being poised to accept and adopt innovative PHR breakthroughs can be expedited by addressing the legal and compliance positions of the hospital in advance.
The detailed strategy must have two major focuses: to determine how health care data will be provided to the consumer and to develop practices to use the consumer-provided data. Of course, the most wired hospitals will need to continue to eliminate the paper chart in order to provide electronic health information.
Choices in the Approach
The hard part is getting data to the consumer. Several evolving options exist to accomplish this, ranging in difficulty and availability.
The first option is to provide data to the consumer through a patient portal integrated with the hospital’s information system. This is a simple way to provide data in a very controlled manner, but it is limited to the patient’s visits to that institution only and does not allow for the consumer to enter and update information.
The next option is to provide data to a PHR supported by the health system, integrating patient visit information and allowing the consumer to enter data.
The range of options ends with a PHR maintained by the consumer with data provided from a variety of institutions. Scanning the occasional paper document and historical data on paper would also be available.
Leverage the Data
As part of their strategy, health care organizations will need to encourage or require the use of the data available from the PHR. At some point, the providers in these most wired organizations will routinely utilize patient-entered information as part of the patient's health history and finally eliminate the repeated manual completion of forms consumers face today.
Effectively using consumer-provided data from a PHR to improve clinical care and reduce administrative processes will require changes to clinical workflows and administrative functions. The most wired hospitals will encourage and train their care providers to use the information provided in a PHR as a standard practice. This should save time and potentially eliminate mistakes.
Providers will be able to quickly review medications and prior lab results. They will be able to see a more complete picture of all providers involved in the patient’s health management. These organizations will be able to electronically include relevant portions of the patient’s PHR in the hospital’s own EMR.
Build for Tomorrow
The vision of consumer-managed personal health records is attainable. However, in order to be successful, hospitals should develop their strategy early and build it to be adaptable to a changing consumer market.
There are many examples of initial PHRs already available from government agencies such as Veterans Affairs, insurance providers, health care providers and independent software vendors. All of these represent fine beginnings to the kind of PHR capabilities consumers will expect, but none of them is complete. Consumer demand will be a powerful driver.
Glenn R. Galloway is co-founder and chief executive officer of Healthia Consulting, Minneapolis.
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This article first appeared on June 13, 2007 in HHN's Magazine online site.
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