Military Health System Personal Health Record

1
Military Health SystemPersonal Health Record

• June 11, 2008
• CDR Jenny Doan

2
Agenda

• Personal Health Record (PHR) working definition
• American Health Information Community (AHIC)
  Consumer Empowerments Charge
• PHR Current and Enhancement
• Implementation Challenges
• Lesson Learned

3
Definitions
Electronic Health Record (EHR) Electronic
repository of health information retained on
behalf of beneficiary providers enter and
access data Personal Health Record (PHR) Set of
electronic tools that enables patients to access
and manage their health information
4
PHR Working Definition

• The Military Health Systems (MHS) Personal
  Health Record (PHR ) is a set of electronic tools
  that enables beneficiaries to access and manage
  their longitudinal health information, to obtain
  personalized health education and risk
  assessments, and to co-manage their medical
  conditions along with the healthcare care team.
• The PHR serves as a communication hub to provide
  relevant information to physicians during
  decision making or health emergencies, to convey
  results of tests and treatment plans, and to
  transmit secured electronic messages between
  patients and providers.
• The PHR lays the foundation for consumer
  empowerment. Empowerment can lead to better
  perception of control and responsibility over
  personal healthcare.
• Increased deployments and relocations of our
  service personnel means that allowing them to
  manage their medical readiness and health records
  is critical to maintaining a ready and healthy
  fighting force.

5
AHIC Consumer Empowerment (CE) Charge

• American Health Information Community (AHIC)-
  Consumer Empower Work Group
• Broad charge Make recommendations to the
  Community to gain wide spread adoption of a
  personal health record that is easy-to-use,
  portable, longitudinal, affordable and
  consumer-centered
• Specific charge Make recommendations to the
  Community so that within one year
• a pre-populated consumer-directed and secure
  electronic registration summary is available to
  targeted populations
• Additional recommendation to the Community so
  that within one year a widely available
  pre-populated medication history linked to the
  registration summary is deployed

6
Assistant Secretary of Defense / AHIC Consumer
Empowerment (CE) Charge

• Assistant Secretary of Defense Charge
• Provide patient WEB access to key portions of
  Electronic Health Record
• By allowing our beneficiaries to take a more
  active role in the management of their health
  care, the Military Health Systems (MHS) hopes to
  encourage communication between our beneficiaries
  and their health care teams and positively impact
  health outcomes.
• Proof of Concept- PHR on TriCare On Line (TOL)
  deployed December 2007 - Demographics, Allergies,
  Medications

7
eHealth - TRICARE Online

• The Military Health Systems TRICARE Online
  Portal serves as the location on the Internet
  where all MHS beneficiaries, healthcare
  providers, and managers conduct their business.
• Provides Secure, Role-Based Access to Support
  Consumer Empowerment for MHS Beneficiaries
• Empowers beneficiaries to become more involved in
  their own healthcare
• TOL currently has 884,526 registered users and
  439,451 active users

8
Current Personal Health Record (PHR)

• Patients authenticated access to PHR through
  acceptable trust standards for MHS systems
• Common Access Card (CAC) users (current) and
  Family Member Account for beneficiaries
• All data is pulled via a unidirectional interface
  with MHS Clinical Data Repository/EHR
• Online Personal Health Record display includes
  
• Read-only display of the beneficiarys
  demographic profile
• Full name, SSN, DOB, gender, marital status,
  race, gender, religion
• Contact info address, home, work, cell phone
  number, email
• DEERS - eligibility end date, enrollment status,
  enrollment facility, assigned PCM, special work
  status, sponsors service affiliation, Medicare
  eligibility
• Other health insurance
• Read-only display of the beneficiarys allergy
  profile
• Allergen description, recorded reaction, date of
  onset, comments
• Read-only display of the beneficiarys
  prescription medication profile
• Over the Counter (OTC), Military Treatment
  Facility (MTF), Network Pharmacy, TRICARE Mail
  Order Pharmacy (TMOP), and Veterans
  Administration (VA) medication data

9
PHR Functionality Overview
Phase I
10
Personal Health Record (PHR) Enhancements

• Pilot at Madigan- Deliverable November 2008
• Establish automated feeds of the EHR into the
  PHR, using Google Health or Microsoft
  HealthVault. The patient will be given the
  choice of repository. The first production
  release will target Google Health
• Connect the PHR to the BHIE framework to allow
  for the passage of individual healthcare
  information to the designated PHR.
• Provide a single interface to connect the
  beneficiaries to their PHR that allows for an
  easy and understandable reference to the provided
  healthcare information.
• Ability for beneficiaries to self-manage their
  health data from multiple sources
• Ability for beneficiaries to share their health
  data with civilian health care providers
• Access to demographics, allergies, active
  medications, lab results (chemistry, hematology),
  and encounter notes.
• Leverage the existing capabilities within the
  Google and Microsoft products to store and manage
  the PHR information.

11
Implementation ChallengesMHS

• Culture Change
• Power Balance Patient and Provider Relationship
• Internet Proficiency and Access
• Distrust of Electronic Avenue
• Loss of Personal Connection
• Security and Privacy
• Territorialism Home-Grown Programs

12
Lessons LearnedPatient and Provider Concerns

• Enable Timely Program Customization
• Usability
• Understand Existing Business Processes Before
  Web-Enabling Them
• System Availability
• Communications with stakeholders
• Marketing

13
Summary

• PHR- Empowers Beneficiaries to Become More
  Involved in Their Own Healthcare
• Human Process Needs Patience and Understanding
• Lessons Learned Communicate, Educate,
  Demonstrate Then Market
• eHealth has to Prove Itself Everyday to Everyone

14

• CDR Jenny Doan, USPHS, PMP
• Director, Access to Care Solutions
• DOD/TriCare Management Activity
• Resources Information Technology Program Office
• 5111 Leesburg Pike, Suite 810
• Falls Church, VA 22041
• O 703-578-2567
• C 202-327-3421
• Fax [phone]
• Jenny.Doan_at_tma.osd.mil