1. 1 Vermont Health Information Technology Plan (VHITP) Educational Presentation Personal Health Records (PHR) Overview / Strategies VITL Board Meeting May 23, 2007 VERMONT INFORMATION TECHNOLOGY LEADERS

2. 2 Agenda Personal Health Records –What are they? –Why are we talking about them now? –What are the types of PHRs? –How do they affect patients? Practitioners? VITL? Implementation Strategy –PHRs in the context of thinking about HIEN strategy –Implementation strategy in the VHITP –A three-step process

3. 3 Personal Health Record (PHR) The idea behind the personal health record (PHR) is that the more consumers know about their health, the more control they will take over it and the healthier they will be. PHRs also encourage consumers to collect and share more health-related information with each of their providers. For this reason, healthcare providers, employers, insurers, vendors, and the federal government are all interested in promoting PHRs. Consumers will hear much more about the personal record in the months and years ahead. Courtesy: AHIMA Personal Health Record Practice Council. "Helping Consumers Select PHRs: Questions and Considerations for Navigating an Emerging Market." Journal of AHIMA 77, no.10 (November-December 2006): 50-56.

4. 4 What is a PHR? No standard definition AHIMA proposed a PHR definition in 2005: –“The personal health record (PHR) is an electronic, universally available, lifelong resource of health information needed by individuals to make health decisions. Individuals own and manage the information in the PHR, which comes from healthcare providers and the individual. The PHR is maintained in a secure and private environment, with the individual determining rights of access. The PHR is separate from and does not replace the legal record of any provider.”

5. 5 Types of PHRs Paper PC Internet Hybrid Employer Insurer Provider Public Health Government Independent for-profit Independent non-profit

6. 6 Questions Content –Demographics, insurance, advance directives, donor, medications, allergies, problem lists, events, hereditary, immunizations, etc. Interoperability –Connected? Standalone? Ownership –Privacy policies? Access –Privacy and Security? Portability –Usability? Cost –Business model?

7. 7 HIENs and PHRs Operator Education Policy Oversight or Rating Convener Data Exchange

8. 8 High-level Strategy When opportunities arise, how do we evaluate their priority for us? How do we develop strategy?

9. 9 Step 1: Evaluating Themes Disease MgmtPersonal Health Records Electronic Health Records Sustainability Broad Use Consistent with VHITP Objectives and Principles Quality Improvement Efficiency Public Image

10. 10 Step 2: Utilize VITL Infrastructure Disease Mgmt Personal Health Records Electronic Health Records CDR EMPI Security Normalization Auditing Interfacing

11. 11 Architecture

12. 12 Step 3: Implementation Strategy Environment Analysis (is the service being met already? Are organizations prepared to offer the service?) Strategic Development Priorities Future business Revenue/Expenses Analysis (ROI) Feasibility End user feedback

13. 13 Potential Strategy Project Review Committee Use the three stage process –Identify priority areas –Select strategic pilots that best exercise the architecture (both technical and non-technical) –Over time we can adjust focus