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)