Where Do I Put My Damn Data?Patient Portals and PHRs

Joe Ketcherside, MD

President & CEO, Cognovant Inc.

Partnership with Patients SummitKansas City MO, September 2012

How do I get my health data? There are different ways to get your data

View of some or all data in a provider’s Electronic Health Record (EHR)

Download a file or printout data from a portal Paper reports generated by your provider Copies of paper-based records and reports

Challenges exist in getting data from multiple providers

It’s difficult to keep up-to-date

Where do I keep my health data? Box in a closet Paper copies in a file Patient portal

Provider keeps the data, but I have access Personal Health Record (PHR)

Key difference between patient portal and PHR – you’re in control, you manage the data Different kinds of PHRs

Tethered PHR Web-based independent PHR Mobile independent PHR

EHR vs. PHR – What’s The Difference? An EHR is a business record a provider uses to

deliver care in a hospital, health system or office Clinical and administrative staff enter the data Used for billing and all clinical activities Record of your care in that organization

A PHR is used by an individual person to manage their health information P stands for Personal You enter your data and manage the content This is a record of your care across time and place

Though there is overlap, these are significantly different

Patient Portals Often a feature of a provider’s Electronic Health Record Lets a patient view some or all of their data in the

record Generally just a subset of the complete record

Only contains information in that EHR Most provide additional administrative features

Secure communication with providers Appointment requests Refill requests Access to educational info or care plans

Doesn’t let you enter your own data Doesn’t move with you when you change providers

Tethered PHR Tied to a provider’s EHR, employer or

insurance company Does let you enter and track your own data Usually populated by the source system Most also provide administrative features Doesn’t contain data from providers outside of

the source system Doesn’t go with you when you change

provider systems or insurance

Web-based independent PHR PHR system hosted independently

Microsoft HealthVault, Google Health (RIP) Database lives on host’s servers, so they

control it Access via browser or mobile device You manage the data yourself Some may link to providers, pharmacies or

other sources Less likely to have administrative connection

to providers You still have it if you change providers, job,

insurance

Mobile independent PHR PHR system runs locally on mobile device Database is locally hosted You control your health data Contains data from multiple sources You can share data with your providers May be able to import data from EHRs Moves with you when you change providers,

jobs, etc. Less likely to have administrative features

Value of PHRs All your health information in one place PHRs aggregate data from multiple sources Longitudinal picture of your health, not just one

provider Complete and consistent source of truth Tools to track important data like blood pressure,

weight, medications, etc. Share patient-sourced data with providers Potential for links to educational resources and

communities or care Critical information in an emergency

Barriers to PHRs Number one barrier is the current difficulty of

gathering and entering data It’s difficult to keep up-to-date once entered Security and privacy concerns Tethered PHRs usually don’t contain data from

other providers Challenges understanding medical

terminology How do you share the data with providers?

Impact of Stage 2 Meaningful Use EPs must provide patients the ability to view

online, download, and transmit their health information within 4 business days of the information being available to the EP

EH and CAH must provide patients the ability to view online, download, and transmit information about a hospital admission within 36 hours of discharge

Transmission of health information is to another provider or to a PHR

Stage 3 expected to require EHRs to incorporate patient-sourced data

This will be the key to reaching the potential of PHRs