PHRs after Meaningful Use: Extending the Provider’s Workflow into the Patient’s Home

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Dramatic changes were afoot in 2007, when the Healthcare Information Management and Systems Society (HIMSS) chartered a committee to explore the potential of personal health records (PHR).  PHR’s were capturing national attention with offerings from leading healthcare and IT brands including WebMD, Microsoft, and Google.  Most were disconnected from the provider’s workflow, leaving HIMSS to ask, what is the value of a PHR from a primary care perspective?[1]

By mid-2009, after expert interviews, literature and research reviews,  the committee came up with 10 benefits a primary care provider could realize through PHR adoption and use.  Seven demonstrated PHRs’ potential to improve healthcare quality and patient safety; three focused on efficiency and lowering the total cost of clinic operations.[2]

At HIMSS10, the Committee debuted its findings and caught the attention of a GE Healthcare team, already working on concepts for its next-generation patient portal.

Many capabilities found desirable by the HIMSS research weren’t available from any commercially available product.  Even the most advanced portals, which had some desired functionalities, lacked features that providers said would help them survive the systemic shift toward collaborative care and outcomes-based payments.

The HIMSS researchers reached three conclusions, left as guideposts for industry consideration:[3]

  • PHRs can be vehicles for innovation in self-service, self-management and more productive patient visits;
  • PHRs can be key components of a practice re-designed to transfer tasks from doctors to support staff and patients themselves and;
  • PHR technologies can be leveraged to increase patient loyalty and improve outcomes.

If GE Healthcare was to act on this information, more specificity would be needed so that its product developers could determine the relative importance of these product features. HIMSS identified more than 30 key attributes of the next generation health information platform. It was up to GE Healthcare to benchmark their relative importance – through the eyes of the paying healthcare providers.

Based on the HIMSS findings, GE Healthcare developed a survey for members of the College of Health Information Management Executives (CHIME).  Though no participation incentive existed, 34 CHIME CIOs completed it.

One important distinction of the GE Healthcare research is the simplification of the HIMSS value prop list by reducing it from 10 value propositions to six and their underlying attributes.  The increased focus made it possible for CIOs to really consider the fundamental jobs that patients and providers must do, rather than a particular PHR or patient portal product.

The GE Healthcare team heard from survey responders that they want a PHR to contain the following:

  • Capabilities to support continuity of care across non-affiliated health systems;
  • Applications that could be leveraged by the marketing organization to gain a competitive advantage;
  • Capacities for communications that go well beyond HIPAA-compliant, secure messaging;
  • Content and tools for engaging patient participation in health interventions;
  • Functionality that delights patients and contributes efficiency gains inside the clinic walls and;
  • Ability to monitors and act prescriptively to guide appropriate patient behaviors.

Signals of an emerging consumer market are everywhere. Body scans, elective surgery, genotyping, and medical tourism are all early indications of the consumer’s willingness to pay for the procedures they deem valuable. These early market trends and sweeping changes to provider reimbursement models combine to give consumers greater exposure to the true cost – and the ultimate ownership of the quality – of their healthcare decisions.

Meanwhile, the barriers to provider adoption of personal health IT are coming down. Government regulations now require secure communications of personal health data and the patient’s right to access it. Challenging though they may be, these mandates have come just in time. According to Manhattan Research, consumers already turn to health web sites more frequently than they do to their own physicians when trying to answer a question about their health. [4]

Information technology and systems will enable healthcare institutions to better compete for patients in the same way it has enabled universities to compete for students. This isn’t the “fuzzy front-end” of the innovator’s product development process.  It’s a future that is in plain sight.  All we need to do is work together to develop and follow the roadmap that will guide us there.

Editor’s note: the complete GE-HIMSS research study was presented during a Webinar on May 2. For information and to access the presentation, visit the HIMSS eConnecting with Consumers Web site. For more information on patient portals, visit the Patient Engagement Knowledge Center at GE Healthcare.com. This article was originally published by Executive Insight.

David Rowe, MBA, is the Global Director of Consumer Product Marketing at GE Healthcare. Mary Griskewicz, Ms, FHIMSS, is the  Senior Director, Healthcare Information Systems for HIMSS.

Illustration

Value of PHR

Figure 1: The value of PHR’s from a primary care provider’s perspective viewed through the lens of GE Healthymagination.

 


[1] “Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care,” Detmer, Bloomrosen2, Raymond, Tang. BMC Medical Informatics and Decision Making, 2008.

[2] “The Value of Personal Health Records from the Primary Care Perspective, V7.3,” HIMSS, March 2009.

[3] “The Value of Personal Health Records from the Primary Care Perspective, V7.3,” HIMSS, March 2009.

[4] Cybertizen Health, 2011, Manhattan Research, Inc.


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