MyHealthBits: Personal Health Record

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MyHealthBits Personal Health Record

• Bambang Parmanto
• Health Information Management Department,
• University of Pittsburgh

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Background Personal Health Record
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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

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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

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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 Ive 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

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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.

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MyHealthBits
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Research Agenda MyHealthBits Focus

• Lifelong/longitudinal
• Health record for everything user interface,
  record management, etc.
• Design schema that meets standard, but meets
  users 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

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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

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Personal Health Records of Everything
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MyLifeBits Records of Everything
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Record View
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Record View MyLifeBits
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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

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Health Records
Personal Information Personal Demographic
Info Emergency Contact Health Condition Major
Illness Problem Lists Medication,
Allergies Family History Advanced Directive,
Care Plan Health History TimeLine Immunization
Lab Tests Imaging Procedures (Hospitalization
Surgery) Provider Visits Personal Health
monitored data (eg., BP, glucose, peak flow )
Healthcare Provider Insurance Providers,
Insurances
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MyHealthBits
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Defining Timeframe
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Selecting Health Record Type
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Preview
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Preview
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Preview web page
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Grid View
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PHR Schema
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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 -gt 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)