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Dr. MohammadAl-Ubaydli
Using PHRs in the NHSResearch evidence and best practices
A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds...
A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds...
A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds...
A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
I was obsessed with handhelds... I’m serious!
A little about me...
Trained as a doctor and PRHO GP
Trained as a programmer and worked at NIH
Honorary Senior Research Associate, CHIME
...and now it’s Personal Health Records
Some definitions
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
Some definitions
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
Data by clinicians for clinicians
Some definitions
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
Easing the patient’s burden•scheduling appointments•ordering medication refills•secure messaging•educational resources•access to EPRSee: Pyper et al. 2004, Ralston et al, 2007.
Some definitions
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
Data by patient for patientPowerful but unstructured
NHSmail users have mailbox shrunk06 Feb 2008
NHS staff who use the health service’s email service NHSmail have been informed that after a recent move to Microsoft Exchange their mailbox size has been capped.
Some 80% of NHS accounts have been capped at just 200Mb, which appears miserly compared with the hefty 6Gb offered by Gmail for free, or the 5Gb offered for free on Windows Live Hotmail.
Some definitions
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
Markle Foundation’s ideal PHR:•Access controlled by patient•Lifelong records•Information from all•Universal access•Private and secure•Transparent•Easy exchange
See: Connecting for Health, 2004
Some definitions
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
What happens when patient uses these tools to take
control of their health care?
Answer will be important for fixing current model
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
GP
NHS specialist A&E
Non-NHS clinicians
What if patient really was at the centre?
Clinicians Patient
Patient portalsElectronic patient records Personal recordsPersonal health records
We don’t know but...
• Sharing information with patients is good (Ros 2003)
• Patients with chronic diseases particularly benefit (de Clerq 2001)
• Interaction better than access (Winkelman 2005)
• Patient-held managment plans improve compliance and care (Giglio 1978, Mellins 2000)
• Co-authorship between clinician and patient creates accuracy and concordance (Kaplan 2001)
• Giving patient decision-support systems may bring major benefits (Barry 1999, Brennan 1998, Leydon 2000)
Acknowledgements
• UnLtd, for their grant to support our PHR research at Patients Know Best
• Dr. Nick Gaunt, for his excellent research and kind help on PHRs
• My co-authors of “Streamlining Hospital-Patient Communication: Developing High Impact Patient Portals”: Jacob Elo and Neha Mahendru with artwork by Docxn Hayes
Using PHRs in the NHSwiki.patientsknowbest.com
