Exploring Challenges and Potentials of Personal Health Records in Diabetes Self-Management: Implementation and Initial Assessment Telemedicine journal and e-health 2007 RACHEL HESS, CINDY L. BRYCE, SUZANNE PAONE, GARY FISCHER, KATHLEEN M. M C TIGUE, ELLEN OLSHANSKY, SUSAN ZICKMUND, KATHARINE FITZGERALD and LINDA SIMINERIO

Introduction Chronic Care Model (CCM) Chronic Care Model (CCM) Clinical information systems provide disease-specific patient registries. Clinical information systems provide disease-specific patient registries. Computer-based decision support for practitioners. Computer-based decision support for practitioners. Development of healthcare system and community change to facilitate longitudinal care. Development of healthcare system and community change to facilitate longitudinal care. Programs to support patients ’ effective self-management. Programs to support patients ’ effective self-management. Institute of Medicine (IOM): Institute of Medicine (IOM): EMR — EMR — The practitioner-maintained portion The practitioner-maintained portion Personal Health Record (PHR) Personal Health Record (PHR)

UPMC Health-Trak

MATERIALS AND METHODS Integration of secure patient messaging into the workflow of practice. Integration of secure patient messaging into the workflow of practice. “ phone tag ” could go on, when office tries to call back. “ phone tag ” could go on, when office tries to call back. The risk of inaccurate transcription. The risk of inaccurate transcription. Convenient for the patient and the physician. Convenient for the patient and the physician.

Results

Patient reactions Provider or diabetes educator could adjust medications during the interval between office visits. Provider or diabetes educator could adjust medications during the interval between office visits. Receive appointment reminders and test results electronically suited their busy schedules. Receive appointment reminders and test results electronically suited their busy schedules. Gave patient the ability to schedule and cancel appointments at their convenience. Gave patient the ability to schedule and cancel appointments at their convenience. Missing lab results, inaccurate information, and slow responses from the physician and/or nurse. Missing lab results, inaccurate information, and slow responses from the physician and/or nurse. Expectations of being able to contact all of their physicians, not just their primary care physician. Expectations of being able to contact all of their physicians, not just their primary care physician.

DISCUSSION The ability to view portions of the EMR, help to ensure that patients are aware of important aspects of their own diseases. The ability to view portions of the EMR, help to ensure that patients are aware of important aspects of their own diseases. Eliminating the need to “ catch the doctor ”. Eliminating the need to “ catch the doctor ”. Requests for medication renewals and physician referrals can be structured so that patients provide all necessary information to process the requests. Requests for medication renewals and physician referrals can be structured so that patients provide all necessary information to process the requests. Users less frequently discussed educational resources, suggesting that simply placing resources within an environment is inadequate to stimulate patient use. Users less frequently discussed educational resources, suggesting that simply placing resources within an environment is inadequate to stimulate patient use.