Implementing eHealth: Development of a Personal Health Record for Patients (Process, Product, and Principles)

Kim Nazi
US Department of Veterans Affairs

Topic: Putting electronic health records online
Track: Practice
Type: Oral presentation

     Full text: Not available
     Last modified: July 26, 2006
     Presentation date: 10/15/2006 1:00 PM in CGEI Telehealth Room
     (View Schedule)

Abstract
Abstract

Introduction
Ehealth, the use of technology and electronic communication to support the delivery and management of healthcare services, offers the rich potential of supplementing traditional delivery of services and channels of communication in ways that extend our ability to meet the needs of our patients. Benefits include enhanced access to information and resources, empowerment of patients to make informed healthcare decisions, streamlined organizational processes and transactions, and improved quality, value, and patient satisfaction.

Process
The VA Healthcare Network Upstate New York (VISN 2) chartered an eHealth Task Force in November 2000, composed of a multidisciplinary team of subject matter experts in critical areas, to support and strengthen the development and implementation of eHealth initiatives and policies in this integrated Network. A SWOT Analysis was conducted to develop areas of focus for our patient population (Journal of Medical Systems, “Journey to eHealth: VA Healthcare Network Upstate New York”, February 2003). In March 2004 the VA Healthcare Network Upstate New York created an Office of eHealth, responsible for strategic planning and project management in leading and coordinating network-wide eHealth Initiatives. The initial task force evolved into a Network Council and local Teams were established at each Medical Center to operationalize initiatives and align implementation with local clinical and business processes.

Product
One major element of our eHealth program is the My HealtheVet Initiative, a web-based application that combines electronic health record information with online health resources to empower and inform patients, and to support patient/clinician collaboration. VISN 2 was selected as a pilot site to foster the development of this personal health record. Experience gained from this pilot has been actively integrated into the national My HealtheVet product and strategy. My HealtheVet includes a variety of customized resources and services as well as access to health information libraries. The ability to record and track information (self-entered metrics) as well as grant access to some or all parts of the personal health record offers additional functionality. The personal health record presents a powerful opportunity to utilize technology as a tool to improve patient access to information, tools and resources, with the core belief that knowledgeable patients are better able to make informed healthcare choices, stay healthy, and seek services when they need them.

Principles
Adoption of eHealth initiatives requires a cultural transformation. Early in the project the resistance of the clinical community became a barrier to implementation. We responded to these challenges by dialoging with clinicians in a variety of forums, assessing and evaluating the concerns brought forward, and developing implementation and process strategies. The patient has a fundamental right to the medical record. This process currently occurs at VA through Release of Information. The impact of accelerating the process through technology needs to be understood and addressed. Clinicians and patients are partners in the health care process. Our best strategy is to, enhance awareness of the availability of the tool, engage clinical staff, and focus on the utility of the tool features in meeting the needs of both groups.

Summary
VISN 2 currently supports more than 375 pilot participants across five Medical Centers. Patient feedback has been extraordinarily positive, and additional studies have been proposed to evaluate impact of the personal health record on overall quality of care, patient satisfaction, compliance with treatment plan, and clinical outcomes.

This tutorial session will include lessons learned from the pilot and implementation of the personal health record, keys to implementation, and clinical case studies.

Educational Goals

At the conclusion of the session, participants will be able to
1. Describe the core elements of an eHealth program and organizational processes required to successfully develop and support the program.
2. Describe the importance of planning and analysis in the identification of areas of focus.
3. Identify desired components of a personal health record for patients and how to create a one stop portal for access to services.
4. Identify barriers to implementation and develop strategies for mitigating risk and cultural resistance.
5. Describe case study scenarios which demonstrate the features and benefits of a personal health record.
6. Demonstrate a deeper understanding of eHealth implementation.

Who Should Attend
Professionals responsible for and/or interested in implementing eHealth Initiatives or programs; Practitioners interested in enhancing their understanding of the benefits of eHealth tools such as the personal health record.

Levels of Content
30 % Basic, 70% Intermediate

Prerequisites:
A basic understanding of eHealth and familiarity with health care are beneficial but not required

References:

Mr. William Feeley
VHA Deputy Undersecretary for Health and Operations

Mr. Gerald Culliton
VISN 3 Deputy Network Director

A/V Requirements:
Power supply, LCD Projector, Microphone