Personal Personal Health Health

RecordsRecordsConnecting the Healthcare Connecting the Healthcare

ExperienceExperience

RoadmapRoadmap

What is a Personal Health Record (PHR)What is a Personal Health Record (PHR) Definition, Components, & GoalsDefinition, Components, & Goals

TerminologyTerminology MarketMarket

Market Size & BenchmarksMarket Size & Benchmarks ProvidenceProvidence Future DirectionsFuture Directions

What is a PHR?What is a PHR?

Functional Functional ComponentsComponents

Patient ApplicationsPatient Applications

•More than just static repositories for patient data

•Combine data, knowledge, and software tools

•Help patients to become active participants in their own care

PHR GoalsPHR Goals

TerminologyTerminology

Stand Alone – Limited to patient-entered and Stand Alone – Limited to patient-entered and maintained informationmaintained information

Tethered PHR – Allows patients to view Tethered PHR – Allows patients to view information from other applications (e.g. information from other applications (e.g. Institutional EMR)Institutional EMR)

Interoperable PHR – Accessible to and through Interoperable PHR – Accessible to and through multiple systemsmultiple systems

Bi-directional PHR – Two-way communication Bi-directional PHR – Two-way communication between EMR and PHR between EMR and PHR

Repository vs. PHRRepository vs. PHR

Adoption PotentialAdoption Potential

75% of consumers want access 75% of consumers want access onlineonlineMedical recordsMedical recordsTest resultsTest resultsAppointment schedulingAppointment scheduling

1 in 4 willing to pay extra1 in 4 willing to pay extra60% would use a PHR if available60% would use a PHR if available

Cross-Industry Cross-Industry ComparisonComparison

Online bankingOnline banking27% growth rate in 200527% growth rate in 200572 million households (76%) by 201172 million households (76%) by 201185% of “Gen Y” will bank online85% of “Gen Y” will bank online

Similarities and DifferencesSimilarities and DifferencesTechnical - security, privacy, sharingTechnical - security, privacy, sharingInformation complexity and need for Information complexity and need for

interpretationinterpretation

Current UtilizationCurrent Utilization

25% of Americans have PHR access25% of Americans have PHR accessCurrently 2-3% actual overall Currently 2-3% actual overall

utilizationutilizationBarriers to adoption:Barriers to adoption:

Difficulty finding, using or Difficulty finding, using or understanding PHR’sunderstanding PHR’s

Lack of “Value” content – beyond Lack of “Value” content – beyond data storagedata storage

Current UtilizationCurrent Utilization

Higher adoption rates in Higher adoption rates in specific systemsspecific systemsLower adoption in repository-Lower adoption in repository-

only systemsonly systemsFunction layers drive utilizationFunction layers drive utilizationEase of access and use are key Ease of access and use are key

driversdrivers

AetnaAetna

Using ActiveHealthUsing ActiveHealthPartnered with HealthVaultPartnered with HealthVaultInstalled in mid-2007Installed in mid-20077% PHR adoption April 2009 (18 7% PHR adoption April 2009 (18

mo)mo)

SSM Healthcare of SSM Healthcare of WisconsinWisconsin

Using Epic MyChartUsing Epic MyChart650 providers650 providers1.1 million EMPI records1.1 million EMPI records0030,000 30,000 activeactive users after 18 users after 18

monthsmonths30% growth during last 6 months30% growth during last 6 months

KaiserKaiser

Using Epic’s MyChartUsing Epic’s MyChart34% PHR adoption (3M users and 34% PHR adoption (3M users and

8.3M members) within 3 years8.3M members) within 3 yearsLab results viewed 150K Lab results viewed 150K 10M+ 10M+Clinician messaging 74K Clinician messaging 74K 3.5M+ 3.5M+Patient portal repeat users 20% Patient portal repeat users 20% 60% 60%

Providence PHR Providence PHR RegistrationRegistration

200,000 200,000 membersmembers

3,000 PHR 3,000 PHR registrantsregistrants

1.5% 1.5% adoptionadoption

Providence PHR Providence PHR UtilizationUtilization

Utilization data is for the last 2 years of WebMD implementation

Functional Functional ComponentsComponents

Current Providence Current Providence PHRPHR

Claims based Claims based data sourcedata source

On-site data On-site data repositoryrepository

One-way data One-way data flowflow

Some targeting Some targeting possiblepossible

Applications

Application Programming

Interface

PHR Data Repository

AdministrativeData Source

Clinical Data Source

Patient Entered Data

Security

Protocol

Security

Protocol

PHR

Rx Hub SureScripts

Non-ProvidenceProviders

PHR

Patient

Providence HIE

Cerner LabStar

Radiology

HCS IS

Centricity

Horizon Clinicals

3rd Party Reposito

ry

Admin Server

Flowcast

Pathways Inpt

Sched

PHR and ConnectPHR and Connect

Shift Away From Shift Away From Claims?Claims?

““Sharing billing Sharing billing data with patients data with patients is unreliable for is unreliable for clinical history, clinical history, and it was a and it was a mistake to do mistake to do that”that”

- Dr. John Halamka, CIO - Dr. John Halamka, CIO Beth Israel Beth Israel DeaconessDeaconess

April 2009April 2009

Shift Away From Shift Away From Claims?Claims?

Google now Google now working with working with National Library National Library of Medicine to of Medicine to codify free text codify free text clinical termsclinical terms

Claims Data ValueClaims Data Value

SummarySummary

PHR’s are a fundamental means of PHR’s are a fundamental means of providing value driven healthcareproviding value driven healthcare

We are currently falling behind We are currently falling behind benchmarks in PHR application and benchmarks in PHR application and adoption ratesadoption rates

Developing a bidirectional, integrated Developing a bidirectional, integrated PHR puts Providence at the front of PHR puts Providence at the front of Healthcare ITHealthcare IT

Questions?Questions?