PHTR 498 Spring 2015 Health Informatics

Patient empowerment and personal health records and Consumers Informatics

“You cannot teach a man anything. You can only help him discover it within himself”. (Galileo Galilei)

Empowerment Patient empowerment is considered a paramount skill in the prescribing arena It can be defined as: 1. “To give power or authority to – to authorize” 2. “To give ability to; enable or permit” Sinclair et al 1999 pp. 468

In health promotion, empowerment is a process through which people gain greater control over decisions and actions affecting their health (WHO 1998). counselling is based on principles of health promotion key issues are partnership, networking and mutual conversation in a confidential relationship recognize patients’ competence, resources, and explanations of action styles as well as coping and support networks patients have an opportunity to plan what to do next, how to go on, and to construct their own solutions to health issues

Professional centred Patient centred Effectiveness & efficiency Value Opinion based Evidence based Event Pathway Organisation Network Structure System Clinical practice peripheral Clinical practice central Money driven Knowledge driven Research findings Systematic reviews (Sir Muir Gray) A new Health System for the 21st Century

Change Our Thinking From Patients are Non-Compliant To Patients are unsuccessful at managing their own care Patients are not yet engaged in their own care

The Facts 40-80% medical information given forgotten immediately; half retained is incorrect 1 Physicians thought 89% of patients understood medication side effects, only 57% of patients understood 2 1. Kessels, R. P. (2003). Patients' memory for medical information. Journal of Social Medicine, 96(5), Training to Advance Physicians‘ Communication Skills. (n. d). Retrieved from AHRQ Website.

Health Literacy The capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Healthy People. (2010). Cited in What is Health Literacy? Retrieved from Only 12% of adults have proficient health literacy Lower literacy = more admissions, ER visits, costs, higher risk of poor health Advocate for Health Literacy in your organization (n.. d.) Quick Guide to Health Literacy. Retrieved from

Teach-Back Method Method to confirm patients understand their medication/treatment: “Tell me why you need this medication” “Tell me how you take this medication” Teach Back not a test of patients’ knowledge Is a test of how well we explain something Kessels, R. P. (2003). Patients' memory for medical information. Journal of Social Medicine, 96(5),

The internet as Marketplace Basically uncontrolled with regards to quality of information No universal quality check No universal index First amendment in full force

Isn’t it time YOU got access to YOUR records and started using it to improve YOUR health and enter the world of REAL-TIME DIGITAL MEDICINE ? Dr. Amir Hannan

What is PHR The Personal Health Record is (an Internet-based) set of tools that allows people to access and coordinate their life-long health information and make appropriate parts of it available to those who need it. (Personal Health Records Working Group, Markle Foundation, 2003) The PHR is an electronic, lifelong resource of health information needed by individuals to make health decisions. Individuals oen 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 does not replace the legal record of any provider (AHIMA e-HIM Personal Health Record Work Group 2005) A PHR is a patient-owned and patient-controlled online record of medical information that is interoperable with other sources of personal health information about a patient (Wes Rishel, Thomas J. Handler, M.D., Gartner, 2008)

Why do we need PHR? Keeping personal health information handy can make consumers- providers communication easier and more efficient Tracking Rx and clinic visits will keep the person current with health issues Makes consumers feel they received higher quality of care Useful in travel or natural disaster

Benefits of PHR Consumer perspective Patients will play a vital role in their health Informed and active individuals in their healthcare will have better outcomes, lower costs (IOM 2001) Empowering the patients (Rassin et al 2006) Promotes adoption of healthy behaviors (Ralston et al 2004)

What do I need for my care?

Appointment setting via EMIS Access

Prescription ordering

Access to full health record

Patient has access to letters

What do I need for my care?

Conclusion eMPOWERed patients need access to their medical records AND high quality information about their care AND how to manage it. e Medical Patient and the Public cOmmunication World wide web Electronic Record