PHTR 498Spring 2015

Health Informatics

Patient empowerment and personal health records

and Consumers Informatics

“You cannot teach a man anything. You can only help him

discover it within himself”. (Galileo Galilei)

Empowerment

Patient empowerment is considered a paramount skill in the prescribing arena

It can be defined as:1. “To give power or authority to – to authorize”2. “To give ability to; enable or permit”

Sinclair et al 1999 pp. 468

In health promotion, empowerment is a process through which people gain greater control over decisions and actions affecting their health (WHO 1998).

• counselling is based on principles of health promotion • key issues are partnership, networking and mutual conversation in a

confidential relationship• recognize patients’ competence, resources, and explanations of

action styles as well as coping and support networks• patients have an opportunity to plan what to do next, how to go on,

and to construct their own solutions to health issues

Professional centred Patient centred

Effectiveness & efficiency Value

Opinion based Evidence based

Event Pathway

Organisation Network

Structure System

Clinical practice peripheral Clinical practice central

Money driven Knowledge driven

Research findings Systematic reviews

2006-------------------------------------2011

(Sir Muir Gray)

A new Health System for the 21st Century

Change Our ThinkingFrom

• Patients are Non-Compliant To • Patients are unsuccessful at

managing their own care• Patients are not yet

engaged in their own care

The Facts• 40-80% medical information given forgotten immediately; half retained is incorrect1

• Physicians thought 89% of patients understood medication side effects, only 57% of patients understood2

1. Kessels, R. P. (2003). Patients' memory for medical information. Journal of Social Medicine, 96(5), 219-222. 2.Training to Advance Physicians‘ Communication Skills. (n. d). Retrieved from AHRQ Website.

Health Literacy• The capacity to obtain, process, and understand basic

health information and services needed to make appropriate health decisions.

Healthy People. (2010). Cited in What is Health Literacy? Retrieved from www.chcs.org

• Only 12% of adults have proficient health literacy• Lower literacy = more admissions, ER visits, costs, higher risk

of poor health

Advocate for Health Literacy in your organization (n.. d.) Quick Guide to Health Literacy. Retrieved from http://HHS.com

Teach-Back Method• Method to confirm patients understand their

medication/treatment: • “Tell me why you need this medication”• “Tell me how you take this medication”

• Teach Back not a test of patients’ knowledge • Is a test of how well we explain something Kessels, R. P. (2003). Patients' memory for medical information. Journal of Social Medicine, 96(5), 219-222.

The internet as Marketplace

• Basically uncontrolled with regards to quality of information• No universal quality check• No universal index• First amendment in full force

Isn’t it time YOU got access to YOUR records and started using it to improve YOUR health and

enter the world of REAL-TIME DIGITAL MEDICINE ?

Dr. Amir Hannanamir.hannan@nhs.net

What is PHRThe Personal Health Record is (an Internet-based) set of tools that

allows people to access and coordinate their life-long health information and make appropriate parts of it available to those who

need it.

(Personal Health Records Working Group, Markle Foundation, 2003)

The PHR is an electronic, lifelong resource of health information needed by individuals to make health decisions. Individuals oen and manage the information in the PHR, which comes from healthcare providers and the individual. The PHR is maintained in a secure and private environment, with the individual determining rights of access. The

PHR does not replace the legal record of any provider(AHIMA e-HIM Personal Health Record Work Group 2005)

A PHR is a patient-owned and patient-controlled online record of medical information that is interoperable with other sources of personal health

information about a patient (Wes Rishel, Thomas J. Handler, M.D., Gartner, 2008)

Why do we need PHR?

• Keeping personal health information handy can make consumers-providers communication easier and more efficient

• Tracking Rx and clinic visits will keep the person current with health issues

• Makes consumers feel they received higher quality of care• Useful in travel or natural disaster

Benefits of PHRConsumer perspective

• Patients will play a vital role in their health• Informed and active individuals in their healthcare will

have better outcomes, lower costs (IOM 2001)• Empowering the patients (Rassin et al 2006)• Promotes adoption of healthy behaviors (Ralston et al

2004)

What do I need for my care?www.htmc.co.uk

Appointment setting via EMIS Access

Prescription ordering

Access to full health record

Access to full health record

Patient has access to letters

What do I need for my care?www.htmc.co.uk

ConclusioneMPOWERed patients need access to their medical records AND high quality information about their care AND how to manage it.

e

Medical

Patient and the Public

cOmmunication

World wide web

Electronic

Record

www.htmc.co.uk