1. PatientSite: Experiences with Shared Health Records

2. 2 PatientSite Project Goals: –Patient involvement –Patient access to information –Secure communication 2 person-years –50% planning and infrastructure –50% programming US$ $250,000 to pilot go-live April 2000

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4. 4 Mail:  Secure  Automated routing  Task assignment Services:  Prescription refills  Appointment requests  Referrals  View bill Records:  Secure  Visit history  Meds/Problems/Results  Personal records Education:  Info prescriptions  Patient selected links  Predefined collections  Videos

5. 5Security Secure Communication Encrypted connections Secure Messaging Audited (Audit trail available to patient)

6. 6 Compose a Clinical Message Compose a Clinical Message

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8. 8 Provider Screen

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10. 1010

11. 1 Service Requests

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17. 1717 Patient Access to Record What should they see? When should they see it? Who else should have access? How should we present it?

18. 1818 Personal Health Record Patient-entered and maintained Data types: –Text –Numeric data –Documents and other objects

19. 1919 Educational Partners PreOp – Patient Education PostCare – Recovery Series UpToDate – Provider Edition UpToDate – Patient Edition Medical Dictionary Multum – medication information database Lab Test Online

20. 2020 –19,200 Patients –168 Attendings (+ 17 NP’s) –320 Office Staff

21. 2121 Messaging Volume Clinical messages: 27.8* Prescription renewals: 3.1* Referrals: 2.1* Appointment requests: 2.6* *monthly volume per 100 patients

22. 2Patients Wide diversity 57% female Median age ~43 –4% over 70 years old

23. 2323 Patient Drivers Secure Messaging with Provider Access to Medical Records Convenience –Request Appointments –Medication Refills –Referrals to Specialists –Review Bills Online Education –Disease specific content by experts at CareGroup –Links to medication information –Personalized drug interaction information

24. 2424Summary Rapid Growth Enthusiastic Use by Patients Strong Provider Acceptance Patients have not abused direct access to providers Significant evidence confirms value to patients, providers and institutions