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Maximizing Personal Health - The Informatics Review

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Maximizing Personal Health - The Informatics Review Powered By Docstoc
					May 13, 2003




“Electrifying”
1/7 th of US Economy


Presentation to TEPR

                   Gary A. Christopherson, Senior Advisor to Under Secretary
               Veterans Health Administration, Department of Veterans Affairs
                                                                                                  Maximize
US Health System                                                                Health/Ability & Satisfaction
                                                            National Health Policy


                                  Care Episode /     Clinical Care                Population,
                                                                                Person/Enrollee,            Death
                                  Chronic Care
                                                      Health Surveillance
                                                                                    Episode
“Community” Environment




                                                                                                                      “Occupational” Environment
                                                     Preventive Measures
                              Quality
                                                          Education
                             Assurance               Evaluation/Diagnosis                             BP/
                                                                                                           H&IT
                                                   In-/Outpatient Treatment                          Ideal
                                    BP/
                                         H&IT       Community Treatment
                                                                                      Community
                                   Ideal
                                                        Rehabilitation
                                                         Information                  Care (Home /
                                  Research &                                           Workplace)
                                  Development                                         Health Surveillance
                                                                                     Preventive Measures
                                                          Status - Well,                  Education
                                                                                     Evaluation/Treatment
                                                      Acute Illness, Chronic
                                                                                        Rehabilitation
                                                        Illness, Custodial               Information
                          Birth                              Direct Care / Info/Prevention
                                           US Health – Goals, Strategic Principles, Outcomes,
                                                                                                              Health
                                                   Leadership/Management, Benefits,
                                                                                                                  Risks
                                          Culture/Environment, Resources, Information, History
Drivers for health
• Maximize health/abilities
• Maximize satisfaction
• Maximize quality
• Maximize accessibility/portability
• Maximize affordability
• Maximize patient safety (defects/errors to zero)
• Minimize time between disability/illness &
  maximized function/health (time to zero)
• Minimize inconvenience (inconvenience to
  zero)
• Maximize security & privacy
Potential timetable to “paperless”
Standards
• Data
• Communications              Adoption by     Paperless
      ---------------------      health        (IOM)
Health Info Systems           organizations
                                              Affordable,
• Electronic Health                           high quality,
  Records Systems                             standards-
  (EHRs)                      Adoption by     based EHRs,
• Personal Health                             PHRs & Info
                                persons
  Record Systems                              Exchange
  (PHRs)
• Info Exchange

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Toward standards & high
performance info systems
• HealthePeople Strategy:
  •Move Federal & Nation to national standards & high
   performance health info systems – EHR, PHR, HIE –
   supporting ideal health systems
• HealthePeople Concept:
  •Collaboratively develop by public & private sectors
  •Support by consumers, providers, payers & regulators
  •Meet consumer, provider, payer & regulator needs
  •Achieve info standards for data, communications,
   security, systems & technical
  •Build/buy & implement high performance systems
  •Public ownership/sharing of at least one high
   performance system for special needs populations
HealthePeople - High Performance Information
Systems Components/Links/Standards
                                                                                                                                                                 My HealthePeople
                                                                                                                                                                   [web site, virtual health
Outside health                                                                                                                                       S           record, trusted information,
                                                                                                                                                                  self-reported information,
organizations                                       “e” communications/                                                                                               link to other health
                                     S                  transactions                                                                                                       providers]

                                             S                                                                S                                          S
 Registration, Enrollment                                                                                                                                             Management &
   & Eligibility System                                                                                                                                               Financial System
                                                 Health Provider (including clinical
                                                 Interface, e.g. CPRS, CHCSII, &
                                                 RPMS) & Data
         Database/                                                                                                                                                                       Database/
         Standards
                                         S       System                Database/                                                                             S                           Standards
                                                                                                                  Standards
                                                     Laboratory System
                 Enrollment System




                                                                                                                                                     S
                                                                                                                  Scheduling System




                                                                                                                                                                                          Provider Payment
                                                                         Pharmacy System




                                     S                                                                                                                           S
                                                                                           Radiology System




                                                                                                                                                                        Billing System
                                                                                                                                      Blood System




                                                                                                                                                                                               System
HealthePeople - High Performance Information
Systems Components/Links/Standards
                                                                                                                                                                 My HealthePeople
                                                                                                                                                                   [web site, virtual health
Outside health                                                                                                                                       S           record, trusted information,
                                                                                                                                                                  self-reported information,
organizations                                       “e” communications/                                                                                               link to other health
                                     S                  transactions                                                                                                       providers]

                                             S                                                                S                                          S
  Registration, Enrollment                                                                                                                                            Management &
    & Eligibility System                                                                                                                                              Financial System
                                                 Health Provider (including clinical
                                                 Interface, e.g. CPRS, CHCSII, &
                                                 RPMS) & Data
          Database/                                                                                                                                                                      Database/
          Standards
                                         S       System                Database/                                                                             S                           Standards
                                                                                                                  Standards
                                                     Laboratory System
                 Enrollment System




                                                                                                                                                     S
                                                                                                                  Scheduling System




                                                                                                                                                                                          Provider Payment
                                                                         Pharmacy System




                                     S                                                                                                                           S
                                                                                           Radiology System




                                                                                                                                                                        Billing System
                                                                                                                                      Blood System




                                                                                                                                                                                               System
                My HealtheVet / My HealthePeople

Other      Electronic Health             My HealtheVet / HealthePeople
health     Record System                 [Personal Health Record System]
organi-                                  “health in a box” on PC & web site via
zations    Software &    Database/       community, health, non-health, government
            Hardware     Standards
                                         Health Record
                                         •Access to health records
                                         •Sharing health records
           S                         S   •Self-entered health record
                                         Services
                               S         •Checking/filling prescriptions
 S          Person                       •Checking/confirming/making appointments
                                         •Checking/paying co-payments
                                         •Participating in support groups
                                         •Health decision support
           S                         S   •Health self-assessment
                                         •Messaging with health provider
Primary                                  •Diagnostic/therapeutic tools
           Electronic Health Record      •Reminders
health                                   •“Checking in”
           System (e.g. VistA)
provider                                 •Safety services/tools
                                         •Links to other health sites
           Software &    Database/
                                         Information
            Hardware     Standards       •Trusted information
My HealtheVet Phasing
• Phase 1
   • Presentation framework
   • Health education content
   • VA developed content (e.g., seasonal health bulletins, health tip of the day,
     Veterans Health Initiatives, interactive chat)
   • Portal personalization features
• Phase 2
   • Rx Re-fill
   • Self Entered Data (excluding self entered metrics)
• Phase 3
   • View Co-pay balance
   • View Appointments
   • Self Entered Metrics
• Phase 4 (Electronic Health Record)
   •   eVAult
   •   VistA extracts
   •   Delegate function
   •   User and system administration functions
My HealtheVet Timeline
  • Summer 2003
     • Foundational online environment with VA-developed
         content, health education information, and self-assessment
         tools
  • Fall 2003
     • Prescription refill and self-entered data*
  • Winter 2004
     • View total co-payment balance, view next scheduled
         appointment**
  • Spring 2004
     • Electronic patient record data and migration from pilot to
         national system***
  * Requires proofing solution in place
 ** Requires Secure Web Transaction Architecture; otherwise, reduced-capability service still possible.
*** Requires Secure Web Transaction Architecture implementation
Potential of “Best Practices” / Ideal Systems
Veteran (and    20+ million veterans not receiving VHA care currently can benefit
their           via My HealtheVet getting trusted info, keep a personal health log,
families) not   store their non-VHA health record, do internet dialogue with health
receiving       advisor, help family & friends get care, form peer-to-peer support
care            groups, be notified of benefit & care site info, be notified of
currently       service-related illness information (e.g. SHAD, Gulf War Illness),
                register/apply for benefits & arrange for first appointment. Ideal –
                Via My HealtheVet, veterans entering VHA for care have already
                established/trusted relationship & VHA already has basic info on
                which to base care; veteran is strong partner in health.
Family of       Via My HealtheVet, can assist veteran with accessing care or
veteran not     benefits, get trusted info, do an internet dialogue with a health
yet receiving   advisor with their veteran family member, form peer-to-peer
care            support groups, be notified of benefit & care site info, be notified of
                service-related illness information (e.g. SHAD, Gulf War Illness),
                register/apply for benefits & arrange for first appointment for their
                veteran family member. Ideal – veterans families feel VHA cares
                & can be trusted; family is strong partner in health.
Potential of “Best Practices” / Ideal Systems
Person (and     People can benefit via My HealthePeople where they get trusted
their           info, keep a personal health log, store their health records, do
families) not   internet dialogue with health advisor, help family & friends get
receiving       care, form peer-to-peer support groups, be notified of benefit &
care            care site info, be notified of work-related illness information,
currently       register/apply for benefits & arrange for first appointment. Ideal –
                Via My HealthePeople, people entering for care have already
                established/trusted relationship & provider already has basic info
                on which to base care; person is strong partner in health.
Family of       Via My HealthePeople, can assist person with accessing care or
person not      benefits, get trusted info, do an internet dialogue with a health
yet receiving   advisor with their family member, form peer-to-peer support
care            groups, be notified of benefit & care site info, be notified of work-
                related illness information, register/apply for benefits & arrange for
                first appointment for their family member. Ideal – persons’ families
                feel health provider cares & can be trusted; family is strong
                partner in health.
National standards & high performance systems

                                 VA, DoD, IHS individual/joint adoption
                                                                                                                   National
                                 Consolidated Health Informatics (CHI)                                              Health
                    Standards


                                                                                                               Information
                                   HealthePeople(Fed)
                                                                                                                 Standards
                                Public/Private
      Health Information




                                •Individual (e.g. Kaiser Permanente)
                                •Joint (Connect. Health, eHealth, NCVHS, SDOs, …
                                                                                                                 Exchange/
                                                                                                                   Sharing
                                    HealthePeople
                                                                                                                      High
                                                                                                              Performance
                                 DoD CHCS II
                                                                                                               Health Info
                                 VA HealtheVet-VistA                                                               Systems
Systems




                                 IHS (upgraded RPMS)
                                                                                                                   Personal
                                   HealthePeople(Fed)                                                                Health
                                Public/Private (CMS, VA, health providers/                                          Record
                                payers/regulators, private sector vendors)                                         Systems
                                     HealthePeople
         2001                                                                                                     2010

Standards – Jointly develop/set/use.                                                        Standards – Nationally accepted.
Systems – Develop/enhance/use high performance, interoperable.                     Systems – High performance, interoperable.
Exchange – Develop two way with computable data.                                   Exchange – Two way with computable data.
Back-up Slide
This & Next Generation Strategy
HealtheVet-VistA
 • Operate current generation VistA
 • Develop, implement & operate HealtheVet-VistA,
    incl. My HealtheVet
 • Develop, implement & operate Next Generation
    HealtheVet-VistA as open source, componentized
    high performance system with partners
HealthePeople, including HealthePeople-VistA
 • Push development & adoption of health information
    standards
 • Push availability & use of public/private sector high
    performance health information systems, including
    NextGen HealtheVet-VistA used externally as
    HealthePeople-VistA, and personal health records

				
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posted:10/15/2011
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