Monday, February 2, 2009

My problem with PHR

PHR seems to be the new panacea for all healthcare ills... vendors and consultants are in a frenzy pitching this new solution that would fix the healthcare system... the noise is huge...

To me though, there are various challenges, the definition of PHR being the first. NAHIT had to spend several hours and meeting with several groups representing different interests to get the definitions right(?) http://www.healthnewsdirect.com/?p=329.

I agree that the patient should have the right to information, but the RIGHT information.
This is where the google concept of letting patients update their clinical information becomes tricky to me.

My key concern is that, though the patient should have access to the information, when it comes to entering /editing clinical/medication/procedure info, that should NOT be left to the patient .

It's nice to have the enduser centric view of the world,but once patients tinker with their prescriptions/procedures etc, we lose the integrity of the data. The physicians cannot use this info as a source of truth and face the legal implications.

Here's my thinking on what a patient would like to see on her PHR.

Clinical& Demographic information
»Demographics
»Social/Family History
»Allergies/Alerts/Immunizations
»Clinical Information
•Diagnoses
•Lab/imaging results
•Rx history
•Inputs from home monitoring devices
•Discharge summary/
Financial
»HSA related information
»Benefits -Co-payments/deductibles etc
»User friendly statements (Explanation of Benefits)
»Medical expense management
Other
»Provider information
»Plan information
»Calendar/Schedule management

In a market place crowded with niche product vendors, each owning a piece of the data,collating all the information and displaying in a standard format is a challenge.However if major vendors,payers and providers collaborate ( which is easier said than done) this can happen.

Some of the providers provide online access to medical records to their patients. I think all providers should do the same, might be a good start.

For more, please view my ppt on role of PHR in an integrated clinical engagement model at http://www.linkedin.com/in/sajisalam