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Showing posts with label Personal Health Records. Show all posts
Showing posts with label Personal Health Records. Show all posts

Thursday, May 5, 2022

Hamilton Health Sciences (HHS) to go live with patient-empowered EMR

 https://www.canhealth.com/2022/05/04/hhs-to-go-live-with-patient-empowered-emr/

HHS to go live with patient-empowered EMR
May 4, 2022


Filomena Canci

HAMILTON, Ont. – In June, Hamilton Health Sciences is introducing its new Epic hospital information system. The electronic solution will make patient records available to clinicians in a centralized location, reducing the need to call up different applications. Moreover, patients will have access to their medical information – including test results, lab results and much more – through the Epic MyChart app.
“Our Vision is to provide ‘Best Care for All’,” says Filomena Canci (pictured), HHS’ chief nursing information officer and one of the leaders working to bring Epic to the hospital. “Not only will Epic improve clinical care delivery and enhance patient experience, it will also help us innovate and remain at the forefront of health care in Canada.”
Epic replaces the current health information system, made up of multiple electronic and paper-based systems containing different parts of a patient’s record. It can be difficult for hospital staff, doctors and other healthcare providers to pull together full patient records with the current system.
Using the Epic MyChart app, patients will also be able to read discharge summaries and consultation notes as well as an after-visit summary document which notes medication changes, orders placed during their hospital visit and any instructions or education provided during their visit.
Patients can share records with their doctors and caregivers, enter their own health information within a secure personal health record space, access health education materials and securely communicate with healthcare providers.
Other features include virtual visits through video conferencing and the ability to upload pictures of, for example, a rash or wound, to help with assessing and monitoring care.
Additional feature of HHS’s Epic MyChart app:

  • eCheck-in: This allows patients to update information such as an address or contact info, medications, allergies, health coverage, and complete questionnaires prior to their HHS appointment. The purpose is to shorten the length of time a patient is at registration.
  • Video Visits: Scheduled video visits with doctors, nurses and other healthcare professionals already take place across HHS – MyChart will make it even easier, with all the info and access in one place, no other online tools required.
  • Notes and Results: Patients can view test results and medical notes from their healthcare team. See your medications, test results, lab results and medical notes. Test and lab results include CT scans, MRIs, x-rays, ultrasounds, echocardiograms, pathology results and lab results such as blood work and COVID testing.
  • Questionnaires: Patients can complete questionnaires within MyChart. These questionnaires could be attached to eCheck-in for certain visits or sent in messages from the care team to patients.
  • Patient-Entered Flowsheets: With these forms, patients can enter medical data, like a blood pressure or blood sugar. The data can be trended over time and can be included in their chart. Abnormal readings can also trigger a message to the healthcare provider to follow-up with the patient.
  • Billing Summary and Details: Patients can pay outstanding balances via MyChart and see details of previously paid bills.
Also available for patients of some clinics:
  • Direct Scheduling: This allows certain clinic patients to schedule appointments with a healthcare provider they already have a relationship with.
  • Appointment Requests: Certain clinic patients can send appointment request messages to healthcare providers they already have an existing relationship with. They can explain why they want an appointment and their preferred availability.
  • Direct Messaging: This lets certain clinic patients send messages to their healthcare providers regarding their medical care or test results. Patients must already have a pre-existing relationship with the person they are messaging in order to reach out this way. Patients will also be able to message about issues not directly related to their medical issue such as billing queries, compliments, complaints and web issues.
With Epic, healthcare providers will understand where a patient has been, and where they’re going in their care journey.
HHS’ current hospital information system is comprised of multiple systems, all containing different parts of a patient’s record. One of the biggest advantages of Epic is its promise of “one patient, one record”, which means that, no matter where a patient is in the hospital, staff and providers will be able to view their full medical history in one unified system. Patients will also be able to update parts of their health record on their own (like medications and allergies) using an app called MyChart.
With Epic, patients won’t have to worry about remembering every detail of their medical history, and providers and staff will be able to make more informed decisions about their care. Using one system across HHS will also dramatically reduce the amount of time providers and staff spend searching for information, enabling them to spend more time listening to patients’ concerns and providing care.
In addition to centralizing most patient records, a major benefit to clinicians seeking information about their patients, the Epic solution will also provide other advantages for healthcare professionals:
Medical professionals are notorious for having hard-to-read handwriting, which can infrequently lead to misunderstandings and errors. For example, misreading a note in a patient’s chart might lead to a wrong dosage of medication.
With Epic, staff and providers will use mobile phones, tables and workstations-on-wheels to update patient information electronically, significantly reducing the chance for errors and patient harm.
A challenge for many patients occurs when they leave the hospital and return to their primary care physician or another external health care provider for care. External providers often need access to a patient’s record to continue providing care, and requesting this information from the hospital can cause unnecessary delays or put pressure on the patient to keep track of everything on their own.
An application called EpicCare Link will make it possible for select external organizations to securely access a patient’s chart, schedule appointments, place orders, communicate with the patient’s hospital care team, and more. This will enable better communication and more effective collaboration between care teams within and outside HHS, improving the patient experience overall.
Over the course of the pandemic, virtual care – including medical appointments by phone or video conferencing – increased by 1,500 per cent at HHS, and it’s unlikely that demand will decrease in the future. Virtual care offers a convenient, accessible alternative for appointments that do not require patients to visit the hospital, and it will be part of HHS’ Epic system.
Staying connected to patients using Epic’s virtual care tools has been shown to reduce unplanned emergency department visits and admissions because providers and staff can proactively monitor patients’ symptoms, medications and progress remotely, and check in using secure messaging and video calls. Post go-live, HHS will explore additional features within MyChart that patients can use to send messages and photos to their care team when they have questions or concerns.
Work is well underway to transform HHS into an Epic hospital in June 2022, and providers, staff and patients all have a role to play. Stay up to date by visiting the Project Odyssey page of HHS.

Friday, October 25, 2019

Axe the fax

From the Globe and Mail December 2018 Health reporter Andre Picard:
https://www.theglobeandmail.com/canada/article-the-british-are-axing-the-fax-will-canada-follow-suit/

It’s not often that a seemingly mundane ministerial announcement reduces one to jealous tears, but this one fits the bill.

On Sunday, Matt Hancock, the British health and social care secretary, banned the purchase of facsimile machines by the National Health Service effective Jan. 1, 2019. He also ordered that faxes be phased out completely in hospitals and physicians’ offices by April, 2020.

Oh, but how Canada – a country even more in the poisonous grip of the fax than Britain – could use this common sense initiative.

“We don’t underestimate the enormity of the challenge to remove all our machines in such a short time, but we cannot afford to continue living in the dark ages,” Mr. Hancock said in the release.

Amen.

In July, the Royal College of Surgeons released a report that revealed the NHS, the country’s publicly-funded national healthcare system, had more than 8,000 fax machines in service. A group of hospitals in Newcastle Upon Tyne had a mind-boggling 603 facsimile machines in use.

To cap it all off, the NHS had the dubious distinction of being the largest purchaser of fax machines in the world.

Richard Kerr, chair of the committee that prepared the report called the situation “farcical” and called on government to invest in 21st century technology.
The government actually listened.

In addition to the fax ban, there are two other important aspects of Sunday’s announcement. Come 2020, communication will be by secure e-mail or apps and, just as importantly, all communication technologies will have to meet a standard that ensure that they can talk to each other across organizational boundaries. 

There will also be some additional money for hospitals and physicians to replace their fax machines – £200-million (about $340-million) – in addition to what the NHS is already spending on IT. 

But we do know that the fax machine is still ubiquitous. A 2017 survey found that two-thirds of Canadian physicians use the fax as their primary means of communication with other health care professionals, such as doctors, pharmacists, and hospitals.

So why do we continue to use technology that is almost universally acknowledged to be absurdly outdated?

Some claim that the fax is more secure than alternatives like e-mail. Our privacy rules also consider the fax the safest form of communication. That’s simply not true, especially with readily available encryption. The continued use of fax machines is bad for privacy and bad for patient safety.

A principal reason the fax endures is habit. Change is always slow in the ultra-conservative health system, especially when it costs money.

But the single biggest impediment to banning the fax is that the computer systems and electronic health records that we have are rarely able to communicate with each other. Interoperability has not been a priority and that has left us beholden to largely paper-based technology.

Many will look at what is going on in Britain with envy. But, in true Canadian fashion, we will find countless excuses for not doing the same.

Expect to hear that, because Britain has a centralized national health-care system, ministerial directives are a lot easier to issue and implement. There is some truth to that; Canada’s 14 ministers of health can barely agree on the time of day, so an initiative to ban fax machines may be a stretch.

But we shouldn’t forget that Britain’s “axe the fax” campaign was a grassroots initiative. The College of Surgeons gave the initial push by providing data that generated a lot of media coverage and made it easy for government to act.
There were also hospitals that showed impressive initiative. For example, the Leeds Teaching Hospitals NHS Trust committed to eliminating its 340 fax machines within three months, sending a message to others that it was doable.
There is no doubt that fax machines can be eliminated, and they must be, sooner rather than later. The only question is who is going to show leadership? What health care organization, hospital, or politician is going to make axing the fax their legacy and drag Canada out of the dark ages?

Friday, February 24, 2017

The myUHN Patient Portal - Infoway Award Winner


The myUHN patient portal has won a second place award from a Canada Health Infoway contest. Here is the presentation they gave:
 http://imaginenationchallenge.ca/wp-content/uploads/2017/02/myUHN-Patient-Portal.pdf

Their infographic on the uptake of the portal is very impressive by the numbers - numbers which have been suggested as viable in research on patient portals (They didn't mention concern for the security of personal health information):
 http://www.uhn.ca/corporate/News/Documents/myUHN_infographic.pdf

The pilot study is over and a full launch began January 30, 2017. It is expected that 250,000 patients will register for it in 2017! Very, very interesting that the portal is integrated into all stages of the clinical experience and by all personnel.

Based on my research on patient portals this looks to be the very promising. Sunnybrook Hospital myChart was also a great pioneer in this area and they have taken a page from their book. It also appears to be an ideal integration solution that I think would work best for a healthcare system.

But what about primary care? Is there an API for that? And why are family docs still so worried about liability or whatever for using a PHR?

Looking closer at myUHN it is very much just a portal or window on the hospital EHR, with a limited but very useful and important set of interaction tools. It is not a personal health record where one can self-report and journal one's health, as is the one developed by McMaster Family Medicine, now called KindredPHR.

If I get sick, I am going to Toronto and the UHN:
 http://www.uhn.ca/PatientsFamilies/myUHN







Thursday, January 7, 2016

Adopting Patient Portals

Interesting article on why patient portals have not caught on yet:

http://www.beckershospitalreview.com/healthcare-information-technology/unlocking-the-value-of-patient-portals-3-thoughts-from-athenahealth.html


Unlocking the value of patient portals: 3 thoughts from athenahealth


Patient portals are meant to conveniently connect patients and providers, but adoption of these tools lags despite a mounting demand from patients for this very capability.


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Tuesday, December 22, 2015

Kaiser Survey Links Portal Use With Improved Perceptions of Health | Healthcare Informatics Magazine | Health IT | Information Technology

Kaiser Survey Links Portal Use With Improved Perceptions of Health | Healthcare Informatics Magazine | Health IT | Information Technology

I posted this link automatically after the story turned up in my google search RSS feed. The website with this Kaiser Survey story had over 280 reference (or Add This ) RSS icon links for sharing the story. I often share stories to my Twitter feed which also has an eHealth theme. My Facebook feed is mostly for personal stories. I can remember before Facebook when RSS was just developing, what a liberation it was from the inbox. Some email programs had a way to receive RSS feeds into a local folder or there was a browser navigation item where one could store the RSS links, kind of like bookmarks. These days I am told that the younger kids don't even read email - they are just message chatting on their smartphones or other social media sites. I still think RSS - Real Simple Syndication - is the greatest technological invention since newspaper publishing. In fact, I have "health informatics" set in a google search feed, which is just an RSS program.

RSS is programmed in XML. I took a course in XML once and started creating my own RSS feeds on the websites I had created. It was not that difficult. XML is also the basis for the HL7 standard for health records and interoperability. It is too bad that more personalized RSS "news" doesn't come into our google or other email accounts in terms of our own personal health records. I personally don't see the interoperable difficulty in doing that. Add to that developments in "web services", API, and inter-database sharing platforms like REST, and there are a lot of open doors for data sharing.

This eHealth enabled browser blog is dedicated to eHealth. Personal health records are a major interest that I like to share with others. After doing research for 5 years on PHR I still think they have many decades to go before they will be widely used. I could be mistaken here, but I just don't think the technology is ripe for wide spread PHR use. It is just not the technology, it is also the social awareness of health and wellness that is lacking.  Newer forms of technology might enable an evolution of this awareness - hard to say. A friend of mine who I follow on Facebook recalled the time in his university in 1990 when he and a colleague decide to get email accounts so they could stay in touch. They could not convince anyone else to use email because no one could see the reason for using a technology that no one else was using.

To get back to this story about the Kaiser Survey that showed that people thought that their health was improving because of using a PHR, I think that there is a need to find more evidence that PHRs can be a technological tool physicians may ultimately prescribe to help their patients. 

Saturday, December 19, 2015

Fall Prevention - From the Optimal Aging Portal

I volunteer with McMaster Family Medicine in the Tapestry program. We visit seniors who have volunteered to be in this research study. We bring an iPad and take a health survey. We also ask if they want to sign in to the McMaster Personal Health Record, which is integrated into the OSCAR EMR.  Many of the clients we have met have had falls.

Just saw this article on the McMaster Optimal Aging Portal about fall prevention. Because I have practiced Tai Chi for more several decades, and because I value the work of the Portal and the plain language systematic reviews and evidence based research they present to the public, I will post this here. It would be great if more people, both citizens and health professionals, could subscribe to the Portal.

Steady on your feet: New ways to improve balance and avoid falls


Dec 18, 2015
When it comes to keeping your feet safely on the ground – metaphorically and literally – it’s all about balance. But like many other things we take for granted when we’re young (strength, endurance, bone density, a full head of hair...) our sense of balance declines as we age. That’s one reason why older adults are at greater risk of falling and potentially becoming seriously hurt or even dying as a result (1).

Past research has shown that regular physical activity can help prevent falls, particularly when it includes exercises and movements designed to improve balance (2). Tai Chi for example, is recommended for its various benefits, including improving strength and balance through slow, controlled movements (3,4).

But if Tai Chi isn’t for you, there are other options you many want to consider. One recent systematic review of six studies measured the benefits of Pilates, a mind-body exercise program that has been popular since the early 20thcentury. Like Tai Chi, it involves controlled movements and concentrates on flexibility, strength, posture and breathing (5). Each study included older adult participants who took part in group Pilates sessions. The exercises varied (mat exercises as well as exercises using elastic bands, weights or other equipment), and included at least 2hrs of Pilates each week. The study participants were compared with a control group who kept up their usual daily activities but did not take Pilates.

Another emerging form of balance training that is gaining attention for its novel approach is “perturbation-based balance training” or balance recovery training. It focuses on improving people’s reaction time and helping them better recover from a loss of balance (6). Training can include equipment (such as moving platforms), or manual interference (such as nudges by a therapist) to enhance your ability to react and stop yourself from falling.

A recent systematic review of eight randomized controlled trials examined whether perturbation-based balance training lowers the risk for falls in older adults as well as people with neurological disorders such as Parkinson’s disease (6). More than 400 people between the ages of 50 and 98 took part in perturbation-based balance training and were compared with those in control group who participated in other types of balance enhancing exercises.

What the research tells us

Both Pilates and perturbation-based balance training appear to be promising strategies for helping older adults avoid falls and the resulting serious consequences.

Despite limitations in the quality of the Pilates studies the results suggest that Pilates is a promising way to help improve balance (5). So far the evidence on perturbation-based balance training is also encouraging: participants completing the training reported fewer falls and were less likely to fall, compared with those in the control groups (6). Further research is needed but there is cautious optimism that this approach may help people react and recover their balance more quickly so that a slip or trip doesn’t necessarily have to end in a fall.

Not sure which balance training exercises are best for you? Ask your doctor or physical therapist, or give these activities a try! At the same time, be aware of hazards and take the necessary precautions (e.g. good lighting, clear pathways, secure handrails etc.) so that you remain surefooted and safe as you enjoy an active lifestyle (7).


The Bottom Line

  • Older adults have a greater chance of falling and experiencing serious injury or even death.
  • Exercises aimed at improving balance have been shown to help prevent falls.
  • Initial studies of Pilates exercises (involving controlled movements to build flexibility, strength and posture) suggest it has the potential to improve balance.
  • Balance-recovery training aims to improve reaction time after a loss of balance and also appears to help lower risk of falls.
  • More high quality studies are needed to learn more about the benefits of Pilates and balance-recovery training.

References

  1. Centers for Disease Control and Prevention (CDC). Falls among older adults: an overview. [Internet] 2012. [cited Dec 2015] Available from: http://www.cdc.gov/homeandrecreationsafety/falls/adultfalls.html.
  2. Gillespie LD, Robertson MC, Gillespie WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012; 9:CD.007146.
  3. Mat S, Tan MP, Kamaruzzaman SB, et al. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review. Age Ageing. 2015; 44:16-24.
  4. Leung DP, Chan CK, Tsang HW, et al. Tai chi as an intervention to improve balance and reduce falls in older adults: A systematic and meta-analytical review. Altern Ther Health Med. 2011; 17:40-48.
  5. Barker, AL, Bird M, Talevki J. Effects of Pilates exercise for improving balance in older adults: A systematic review with meta-analysis. Arch Phys Med Rehabil. 2015; 96:715-723.
  6. Mansfield A, Wong JS, Bryce J et al. Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials. Phys Ther. 2015; 95:700-709.
  7. Public Health Agency of Canada (PHAC). You Can Prevent Falls. Ottawa, Canada. [Internet] 2011. [cited Dec 4, 2015] Available from: http://www.phac-aspc.gc.ca/seniors-aines/publications/public/injury-blessure/prevent-eviter/index-eng.php 



AUTHOR DETAILS

Optimal Aging Portal Blog Team

The latest scientific evidence on this topic was reviewed by the McMaster Optimal Aging team. Blog Posts are written by a professional writer, assessed for accuracy by Dr. Maureen Dobbins, an expert in interpreting and communicating the scientific literature, and edited by a professional editor. There are no conflicts of interest.

Thursday, October 22, 2015

myCARE patient portal

http://www.canhealth.com/2015/10/new-patient-portals-launched-but-lots-more-needed/

New patient portals launched, but lots more needed

Alex LambertSAULT STE. MARIE, Ont. – The Group Health Centre in Sault Ste. Marie, Ont., has joined the ranks of healthcare organizations offering a patient portal with secure access to test results and much more.

The Group Health Centre has launched myCARE, a secure online patient portal that provides patients with the ability to send messages to their healthcare team, request prescription renewals, manage appointments, and review lab test results online.

A survey of the more than 1,500 patients who were involved in the pilot phase reported that:
• 99 percent of patients surveyed would recommend myCARE to a friend or family member
• 97 percent agree that myCARE is user-friendly
• 93 percent agree it was easy to register
• 90 percent agree it’s easy to use

Alex Lambert (pictured), CEO of Group Health Centre, is confident that the launch of myCARE will help improve access to care and advice for patients.

“We believe healthcare is most effective when patients are engaged,” he said. “myCARE offers patients a number of unprecedented options for access, information, and communication. This kind of patient engagement leads to better outcomes for everyone involved.”

Michael Green, president and CEO of Canada Health Infoway, wants to maintain the momentum.

“While Canadians are ready for e-booking and viewing lab results online, only 6 to 10 percent have access now,” added Green. “The potential to enhance Canadians’ patient experience by improving care and reducing the amount of time required to renew prescriptions, book appointments and manage illness has never been greater than it is today.”

That view is echoed by leading Canadian health care organizations who have established Digital Health Week (November 16 – 22, 2015) to recognize how digital health is transforming care and helping to improve delivery of care across the country.
Think digital health isn’t making a difference? Think again. Visit www.betterhealthtogether.ca.

Wednesday, July 1, 2015

Fitbit and Personal Health Informatics

A surprise gift for father's day was a Fitbit ChargeHR. The HR stands for Heart Rate, that measures beats per minute (BPM). It doesn't measure blood pressure, and I don't think any device like this on the wrist will be able to do that soon. I have been counting my walking distances, steps up stairs, calories and sleep activity for about a week now. It feels good to have entered the world of the "quantified self "and big data personal health informatics at more than just a theoretical level, as I have been doing on this blog for the past 4 years. I actually have a blog post about Fitbit from 3 years ago <here>!

The data is sent wirelessly to a small "dongle" on my MacBook anytime I am within 20 feet of it. I was surprised to see how this data easily integrated with Telus (Microsoft) Health Space (Healthvault) from the Fitbit.com login settings account. The power of the API is truly awesome.

As I knew before when I was looking at reviews for smart watches, the Fitbit ChargeHR is not a great watch for telling the time. However, one advantage is I find myself saving a lot of time by not looking at my watch to find out what time it is so often. All in all, I find myself wanting to wear it more than the old watch.

Sleeping with the watch is perfectly unobtrusive. There are continual double green sensor lights flashing for the BPM readings but it is hidden under the wrist. At a different viewing angle you can see the green lights. Double tapping at night will illuminate the clock (and day of the month) but during the day it is very difficult to see the digital time in glare of light of day. When you wake in the morning, sleep activity data is automatically transmitted to the MacBook or the Fitbit app on the iPad. via the dongle. The sleep data is a bit hard to interpret. Did I really only get 5 hours sleep? Anyway, I am starting to make some sense of the times I may have been awake or restless.

If you set a goal for 10,000 steps it will buzz on your wrist when you achieve the goal. You are also sent an email congratulating you, which is repeated in the weekly email data digest updates. I tracked food consumption for data on calories, sodium levels, etc. for a few days, and this is very interesting information for me. Since I have not really changed weight since I was a teenager, I don't really have any weight goals, but I know I can align readings from the gym equipment which tracks BPM and calories burned with the Fitbit. When I am not going to the gym, I can utilize those readings. But like I said, watching calories burned is not a science I follow much because of my metabolism.

Even though the data is integrated into the Telus HealthSpace, which is a free personal health record if you have a Microsoft login, I still don't find myself using the personal health record that much (yet). I also have a McMaster PHR (former MyOSCAR) and a Health and Wellness Companion PHR through my employer's health insurance company, in both of which I have just stepped into the shallow end of the pool. I tend to keep a Word document log and paper file of health related events a lot more. If the PHR was integrated with our family health team, I am sure I would use it more.

So, I think we are still a way off from wider adoption of personal health records as integrated tools for the physician's electronic medical record. A lot depends on more research, and of course evolving software breakthroughs like APIs. I am a community volunteer with the McMaster University Family Medicine TAPESTRY program, and I can see first hand the uptake on PHRs and how much education and training is required before they are being used effectively. On our visits to seniors in our communities we also help promote the use of the McMaster PHR. Like any technology, and the toothbrush comes to mind, use comes from developing good habits, as well as promotion from health care professionals.

Because we have entered a digital culture, many people will be entering a personal health record, not through their family medicine clinic, but through some form of personalized health informatics, like Fitbit data, or smart phone apps. There will be a point when physician medical practices will want to buy into accessing or making that data available.


Wednesday, February 4, 2015

Personal Health Record Push to Apps

I sometimes follow the HL7 group on Personal Health Records. I received this email from a member of the group. I find it interesting that pushing medical records to a personal health record is becoming better:

NBB4C makes it easier for providers to share health information with their patients so that their patients can do what they want with it.





February 2015



Clearing the Way for Patients to Get Access to their Data
National Association for Trusted Exchange Unveils New Trust Community for Exchange with Consumers
WASHINGTON, D.C. (February 3, 2015) – The National Association for Trusted Exchange (NATE) today kicked off its new NATE Blue Button for Consumers (NBB4C) Trust Bundle at the 2015 ONC Annual Meeting with a surprise display of interoperability in patient-mediated exchange.  Shortly after NATE’s announcement, Greg Meyer, Director, Distinguished Engineer, Cerner Corporation, demonstrated how a provider using a Cerner electronic medical record (EMR) can simply push a patient record to the patient's personal health record (PHR), in this case to the Humetrix iBlueButton app running on the patient's smartphone.

The new NBB4C Trust Bundle helps relying parties to identify consumer facing applications (CFAs) that meet or exceed criteria considered to be the most important characteristics of a trustworthy steward of consumer health information, while still enabling patients to benefit from the value of having access to their health information.  Participation in the trust bundle will facilitate secure exchange of health information from provider-controlled applications to consumer-controlled applications such as PHRs using Direct secure messaging protocols.

“Thank you to my colleagues at Cerner and Humetrix for helping NATE demonstrate the capabilities of the new NATE Blue Button for Consumers Trust Bundle at the ONC Annual Meeting.  Greg’s demonstration today shows that the NBB4C is ready now to enable real world exchange between provider-facing applications and consumer-facing applications, empowering the consumer to get access to their data,” said NATE’s CEO Aaron Seib.  “Our industry achieved a major milestone today.  We studied the issues around securely sharing information from providers to patients and together we took a leap of faith.  Consumers across the country will now have more control over their care.  NBB4C gets the information flowing to where it should be: in the hands of the patient.  I look forward to the day when patients across the nation routinely download their health information into a consumer-facing application of their choice and use it to improve their lives and the lives of those they love.”

The NBB4C Trust Bundle is the result of the next generation of NATE’s ongoing PHR Ignite Project and incorporates lessons learned from NATE’s administration of the Blue Button Consumer Trust Bundles.  Over the past year, NATE and a task group made up of thought leaders in the patient-mediated exchange space worked together to develop a set of criteria and expectations that balances what is a ‘must have’ for today and what can wait until tomorrow, what is practical as a starting point and what is a showstopper that would kill consumer engagement if introduced.  In November 2014, NATE crowd sourced the trust framework, calling for and receiving comments from across the industry.  In January 2015, the NATE Board of Directors approved the workgroup’s recommendation for release into production.

“The NBB4C establishes a practical framework that will enable patients to securely exchange health information with their providers without burdening the patient with unnecessary steps to obtain their data and share it with whomever they choose,” said MaryAnne Sterling, Consumer Ombudsman for the NATE Board of Directors.  “As a long time caregiver for my aging parents, this work is important to all of us who manage healthcare on behalf of others.  I have confidence that applications participating in the NBB4C will meet or exceed my expectation that my family’s health information will be confidential and secure.”
Interested CFAs may begin onboarding to the NBB4C Trust Bundle now at http://nate-trust.org/trustbundles.  Stakeholders interested in participating in the next phase of NATE’s work in consumer-mediated exchange should consider NATE membership or subscribe to news from NATE’s PHR Community.
# # #
NBB4C makes it easier for providers to share health information with their patients so that their patients can do what they want with it.
About National Association for Trusted Exchange
The National Association for Trusted Exchange (NATE) brings the expertise of its membership and other stakeholders together to find common solutions that optimize the appropriate exchange of health information for greater gains in adoption and outcomes. Emerging from the Western States Consortium, a pilot project supported by the Office of the National Coordinator for Health Information Technology (ONC), NATE was established as a not-for-profit organization in May 2013. Consistent with NATE’s mission to address the legal, policy, and technical barriers that inhibit health information exchange between entities within a state and across states, NATE leads and participates in a number of ongoing and emerging projects in the HIE domain. NATE has been operating its own Trust Bundles in production since November 2012 and recently took over administration of the Blue Button Consumer Trust Bundles.  Working with a broad set of stakeholders through multiple task forces, crowdsourcing and a call for public comment, NATE is proud to make available the first release of NATE's Blue Button for Consumers (NBB4C) Trust Bundle beginning in 2015.

About Cerner 

Cerner’s health information technologies connect people, information and systems at more than 18,000 facilities worldwide. Recognized for innovation, Cerner solutions assist clinicians in making care decisions and enable organizations to manage the health of populations. The company also offers an integrated clinical and financial system to help health care organizations manage revenue, as well as a wide range of services to support clients’ clinical, financial and operational needs. Cerner’s mission is to contribute to the improvement of health care delivery and the health of communities. Nasdaq: CERN. For more information about Cerner, visit cerner.com, read our blog at cerner.com/blog, connect with us on Twitter at twitter.com/cerner and on Facebook at facebook.com/cerner.
As of February 2, 2015, Cerner Corporation acquired Siemens Health Services.  Certain trademarks, service marks and logos set forth herein are property of Cerner Corporation and/or its subsidiaries. All other non-Cerner marks are the property of their respective owners.
About Humetrix
Humetrix has pioneered the development of innovative consumer-centered IT solutions over the past 15 years, which have been deployed around the world.  The company’s award winning Blue Button enabled apps are the mobile embodiment of the U.S. Federal government Blue Button initiative available to more than 150 million Americans. Humetrix’s HHS award winning emergency and disaster preparedness mobile apps are now being advocated by EMS agencies across the US and were demonstrated at the White House Innovation for Disaster Response and Recovery Demo Day last summer. For more information, visit www.ibluebutton.com and www.humetrix.com


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Contact email: meryt.mcgindley@nate-trust.org

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Tuesday, January 27, 2015

Personalised Medicine and/or Personalised Health Information Services

I came across a website and eHealth service recently called Medivizor. Seems like I have had the wrong idea about what "personalised medicine" means. I needed to enter it as a search term in Pubmed and discovered 932 articles that had nothing to do with my idea of it. That is, my idea was more in line with the health information services provided by Medivizor. The articles I found in Pubmed were more like "personalized genomics or pharmaceuticals". For example, this article: "Metabolomics as a tool for drug discovery and personalised medicine. A review."

While there may be nothing wrong with that, especially if they want to use genomics to replace parts in me, my idea had more to do with the kinds of health information one should be getting through a personal health record (ePHR), depending on one's own unique state of health. But if I do a Pubmed search on "personalised medicine and personal health records", I get almost exactly what I am thinking about (but only 6 articles). The first article is called:

Wang HQ, Li JS, Zhang YF, Suzuki M, Araki K.
Artif Intell Med. 2013 Jun;58(2):81-9. doi: 10.1016/j.artmed.2013.02.005. Epub 2013 Mar 5.
People search the net for health information and Google is a vast resource. It is better to narrow the scope and only get the health information related to one's personal conditions or searching - be they chronic or not - and to make sure that information is trusted. The Optimal Aging Portal is one such service, but at the current time, that information isn't being personalised or fed into individual ePHRs. All is not lost: patients do have their family doctor for personalised medical attention. End of story.

Getting that trusted health information, if it isn't directly from your family doctor, is a work of monumental scientific promise. A recent overview article that caught the interest of the health informatics community is found here: "Stop Googling your health questions. Use these sites instead":
 http://www.vox.com/2014/9/8/6005999/why-you-should-never-use-dr-google-to-search-for-health-information
That's a lot of knowledge translation to get healthcare consumers to wise up about the health information they are seeking.

The best idea would be if the there is a health informatics professional(s) in the family health team who can work in consultation with the family doctor so that personalized and trusted health information most relevant for them is getting to them through the ePHR. Can't leave it all up to AI and algorithms, but who knows?