Maximizing Personal Health - The Informatics Review
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Document Sample
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
