Tuesday, February 03, 2015

#ONC2015 Advancing Consumer Mediated Exchange

Advancing Consumer Mediated Exchange (Jefferson East)

This session will highlight real examples of consumer-mediated exchange occurring across the country including implementation approaches and tactics. You will learn what systems need to be in place to support consumer mediated exchange or the implementation of new technologies. Learn the benefits that have emerged from successful consumer mediated exchange. This session will also delve into the challenges and opportunities that will enable a future with more robust consumer mediated exchange activities.

  • Ryan Bosch, M.D. FACP M.B.A. CPHIMS, Vice President of Informatics, Chief Medical Information Officer, Inova Health System (@InovaHealthWeb Site Disclaimers)
  • Janet Campbell, Senior Architect, Epic
  • Dave Meyers, CTO – Health & Human Services, Microsoft Health & Life Sciences (@Health_ITWeb Site Disclaimers)
  • Dina Passman, Lieutenant Commander, US Public Health Service and Public Health Advisor for Health IT, SAMHSA (@notjustanepiWeb Site Disclaimers)
  • Eileen Rivera, Consumer Representative
  • Lee Stevens, Director, State Health Policy, ONC
  • Jim Younkin, Director, Keystone Health Information Exchange

New Community of Practice from ONC for HIE systems offering PHR services. Caroline Coy is leading the initiative.

What has ONC done around C-ME? What is the next step?

Interoperability is a big issue. You have to be able to get your records.

Will people actually use their Personal Health Records?

What are the business cases for C-ME?
Why do providers want to do it?
Why should hospitals go to the next level of connection?


Eileen Rivera: What have been the gaps in care when moving between providers?

In the summer was reflecting on arrival at 2nd hip replacement.
As a teenager had a collision with a car and an un-diagnosed hip fracture that stayed un-diagnosed for over 30 years..

If she had access to her medical records she could have had a better conversation with specialists. She had confused hip pain with back pain.
Unable to share information with each doctor.

We have to be our own advocates.

Dr Bosch, Innova: What is important about engaging patients in their care?

11 Hospitals and 400 ambulatory clinics. Uses MyChart for blocking and tackling. Excited to move medications, allergies with the patient. Built in to the portal the ability for patients to submit information prior to major surgery and treat that as structured data.

Consumer supplied data creates an opportunity for transformation to relationship-based care.

Janet Campbell, EPIC: what was important in creating LUCY

15 years ago when MyChart was introduced. MyChart is a portal and the data lives in the source organization. Patients ended up with multiple MyCharts.

LUCY extended the capacity of MyChart and store information separate from the source organization and then share with others. Any downloadable data is uploadable to LUCY. LUCY provides a Direct Address.

EPIC sees LUCY as an extension of MyChart.
50 Organizations can exchange data with LUCY. Utilization is low. Because People may just use MyChart.
About 200,000 patients use LUCY.

LUCY was extended to support upload of non-standard documents. If third party portals enable Direct email then they can send data to LUCY.

No Transmit function in LUCY – that is through MyChart.

Jim Younkin – Keystone HIE: Why did they offer a C-ME?

Keystone established in 2005. 38 participant organizations including Geisinger. Now is a community-based exchange.
Participated in the Beacon Community initiative. Looking to engage patients to improve critical illness care.

Lots of care took place outside Geisinger system. Patients needed a tool to engage in their care. So they wanted a PHR that sat on top of HIE. MyKeyCare.

Needed to be able to scan in paper records. Work with an outside vendor to scan their 3-ring binders.
Today about 4M patients in HIE. Having the PHR helped providers meet MU2 measures. Access to underlying record and provide messaging features.

Providers are conscientious about meeting MU incentives. Any health care provider can get MU Reports from the HIE.

When a patient looks at their record any provider gets credit for VDT Measures if they were involved during the period in providing service.

SHINY in NY creates a view for patients across all providers.

Dina Passman – SAMSHA: Behavioral Health is important to share. How do Consumers feel about sharing that data?

Consumers have concerns.

Consent to Share is compliant with CFR42 part 2.
Piloting in Prince George’s County

Dave Myers – Microsoft: PHR Ignite – what is Microsoft’s role in supporting access?

Children’s hospital in Dallas wanted to see how kids with sickle cell disease would use an untethered PHR. These kids say about 32 different providers.

The population fell into category of people that were felt unlikely to use the technology. Lower income, younger mothers. The response to access was astounding with high adoption.

Couple of things for data exchange:
1. HIPAA compliance
2. trustworthy system/cloud (scalability, manageability etc)

Healthvault is free to consumers. Developers can write apps to integrate with healthvault.

Microsoft health announced in October to capture fitness and wellness data. Eg. Microsoft band ( battery only lasts about 2 days).

Dade county, FL is using healthvault and smartphone to manage diabetes.

Eileen Rivera: using wearables

Uses yoga to help in hip replacement recovery.
Until physicians will accept the data it is of limited value.

Consumers are asking for integration.


Why can’t I get my data? What standards

Actually asking for BlueButton.

Can we consolidate records from multiple sources?
Do we understand the business drivers to drive interoperability?

biggest challenge is data is seen as a competitive advantage

It’s the patient’s data! Providers have to give the information. We need to work on tools to make this easier.

Consumer choice is important. Plenty of patients get care from multiple places. They should have choice about how they store their data.

Data hoarding precludes other advantages of interoperability.

Don’t be shy in offering comments back to the ONC. Eg. “Standardize the fields in the CCD”
Send in your feedback!

[category News, Health]

[tag health cloud, blue button, ONC2015, CME, Medyear]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark@ekivemark.com
Stay up-to-date: Twitter @ekivemark

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.
Medyear: Less hassle. Better care.

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