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TIGER Vision

Allow informatics tools, principles, theories and practices to be used by nurses to make healthcare safer, effective, efficient, patient-centered, timely and equitable

Interweave enabling technologies transparently into nursing practice and education, making information technology the stethoscope for the 21st century

TIGER Website

http://www.tigersummit.com/

TIGER Collaboratives

Fully Engage in HIT Standards and Interoperability Development

Fully Engage in the National Healthcare IT Agenda

Create Comprehensive Informatics Competencies for All Areas of Nursing

Reform Educational Curriculum, Faculty and Program Development

Create Innovative and Effective Staff Development/Continuing Education Programs

Improve Clinical Applications Used by Nurses

A Virtual Demonstration Center to Showcase Healthcare Information Systems and Technology for Nurses

Engage and Support Nursing Leadership

Engage and Support Healthcare Consumers

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Work Group 3

TIGER Consumer Empowerment & Personal Health Record Collaborative

Work Group 3

Working together using this wiki

This wiki is a shared online whiteboard that allows the entire group to easily share information to each other and other TIGER collaborative team members. The material on the wiki should be considered to be in draft format and will be published on the TIGER website at www.tigersummit.com upon completion.

Activities of Work Group 3

This work group will prepare a current "state of the science" overview on consumer empowerment and personal health records as outlined below. It is intended that this team's work will use the wiki to develop and post content and be concluded by July 1, 2008.

Content Outline

(Note: We are looking for members to select topics and/or contribute content to these sections. Please post a brief annotation or explanation with each item anywhere under the outline listed below.)

Personal Health Record - Overview

1. Current state - definitions and standards (use work from WG #1 and WG #2) - David Sweet/Don Mon (standards/AHIMA/CCHIT)

Personal health records definitions benefits and strategies for overcoming barriers to adoption.pdf

2. PHR offerings, markets, and suppliers in use today - NLM and AHIMA collaborative - David Sweet

Cite key examples and discuss trends (www.myPHR.com); Whatcom County, WA -- "Shared Care Plan"; www.sharedcareplan.org

CMS example http://www.healthcareitnews.com/story.cms?id=9229&page=1
10-event series on PBS related to PHRs - AHIMA - Craig May/Hugh Downs - scheduled for June start (Donna to contact)
Work with HIMSS PHR SIG (Charlotte/Rita/Donna)

3. Nurses' role in use/care delivery - WG#4 results (Rita)

Adapt AHIMA survey questions for nursing. (Donna, Rita, Charlotte Ruth,Julie) Use ANI and member organizations to distribute survey. Needs to be completed with results by end of July
AHIMA survey results. Executive Summary written by Julie Wolter;

http://library.ahima.org/xpedio/idcplg?IdcService=GET_HIGHLIGHT_INFO&QueryText=%28Defining+the+Personal+Health+Information+Management+Role%29%3cand%3e%28xPublishSite%3csubstring%3e%60BoK%60%29&SortField=xPubDate&SortOrder=Desc&dDocName=bok1_038473&HighlightType=HtmlHighlight&dWebExtension=hcsp

4. Expert sources, web sites, grants, references, major conferences

Web sites

myPHR.com (AHIMA)

Conferences

Center for Business Innovation (CBI)/California for Telehealth Center - July 7-8,2008 - San Francisco, CA http://www.tcbi.org/hu2008/index.htmlHU_2008_Brochure.pdf - Fifth Annual Healthcare Unbound Conference & Exhibition
A Conference & Exhibition on the Convergence of Consumer & Healthcare Technologies

Special Focus on Remote Monitoring & Home Telehealth

for Managing Diseases & Promoting Wellness

Markel Foundation

Markel - CommonFramework report http://www.connectingforhealth.org/resources/CCPolicyBrief.pdf Grants

AHRQ
RWJF's Project Health Design

Contracts

CMS
ONC
- HISPC Collaborative (contract)

http://privacysecurity.rti.org/ national web site for HISPC; KU's site for consumer education content and tools at: http://www2.kumc.edu/healthinformatics/HISPC/CEEC.htm

5. Health policy trends - incentives for consumers, providers, etc.

Connecting for Health - News - Press Release.htm

(NCQA: Washington) -- The National Committee for Quality Assurance recently launched a new version of its physician practice connections (PPC) program designed to assess how medical practices are functioning as patient-centered medical homes. The new PPC—patient-centered medical home (PPC-PCMH) emphasizes the systematic use of patient-centered, coordinated-care management processes; click on the link below for the full article: http://tinyurl.com/2epd32

A) CMS role - (Suzie)

B) ONC - AHIC and CCHIT (Donna)

C) AHRQ (Suzie/Charlotte)

D) Proposed legislation

Patrick Kennedy - (Ruth W.)
Health Record Banking (Suzie)

Consumer Empowerment - Overview

1. Consumerism in Healthcare - definitions and standards (use work from WG #1 and WG #2)

2. Trends in promoting consumer behavior

ConsumerInternetUse.pdf recent survey done by CHCF

CHCF 2008 HelpingPatientsPlugIn.pdf New report from CHCF on consumer use of online tools, including case examples from 5 states

OCR Releases HIPAA Privacy Consumer Brochures in Eight Languages.doc recent announcement by OCR on consumer education of HIPAA

3. Health literacy

Definitions for consumerism and health literacy (AHRQ - pharmacy info pkg for consumers, providers, etc. - Susan)
- An overview of health literacy and the adoption of PHRs done by US Surgeon General's office provided by Ruth WalkerCynthia_Baur_healthliteracy.ppt
Behaviors around consumerism and health literacy

Understanding Your Caregivers_JCAHO.doc

https://www.google.com/health/html/about/ Google Health has section of health information data

http://blogs.patientempowerment.net/?p=24 Patient empowerment blog with information about Kroger memory sticks

Strategies to improve health literacy for vulnerable populations (e.g., spanish-speaking kiosks - Hahn - Susan)

6. Programs to address/drive/promote consumerism

Partnering strategies to promote further research and develop new business opportunities (e.g., Microsoft/academic, Microsoft/Kaiser Kaiser backs Microsoft Patient Data Plan.doc, Wellpoint 360 at Anthem.com http://www.welldoc-communications.com/news.html

, etc.)

7. Health policy for implementing consumerism

States
Grant designed to provide better access to vulnerable populations--e.g,. disabled (Ruth - MN St. Scholastica), Regional; Federal (Linda obtaining information from Susan Daniels on disabled population) PHR_Policy Expert on Disabilities.doc
Enabling legislation
- Health Record Banking Alliance (Suzie) http://www.healthbanking.org/docs/HRBAPrinciplesMay07.pdf
- Health Record Banking - State level (Kansas)
Economic models; health insurance - paying for prevention

Provider-Payer focused

CMS example http://www.healthcareitnews.com/story.cms?id=9229&page=1
My HealtheVet http://www.myhealth.va.gov/

8. Models of care that enable consumer empowerment and patient-centered care (e.g. On-Lok; EH Wagner,MD; Bodenheimer-Chronic care model, "Medical Home", Patient-Centered Care Center, etc.) - Nancy Fahey

http://content.healthaffairs.org/cgi/content/full/20/6/80#SEC2 – Health Affairs - Consumer-Directed Services At Home: A New Model For Persons With Disabilities

http://www.hhs.gov/healthit/ahic/materials/summary/cesum_091207.html American Health Information Community Consumer Empowerment Workgroup

http://www.ura Complete list of winners of the Best Practice in consumer Empowerment and Protection Awards

http://www.ihi.org/IHI.Topics/ChronicConditions/Diabetes/Tools/ChronicCareModelAudiovisualPresentation.htm A 57 minute presentation on Chronic Care Model by Dr. Ed Wagner, Director of Improving Chronic Illness Care national program.

http://improvingchroniccare.org/change/model/modeltalk.html American Academy of Family Physicians (AAFP) access to Chronic Care Model

http://www.medicalhomeinfo.org/Joint%20Statement.pdf The Patient Centered Medical Home (PC_MH) approach to providing comprehensive primary care for children, youth and adults.

http://www.hhs.gov/healthit/documents/ConsumerEmpowerRegMedUseCase.pdf

http://www.bcbs.com/news/bcbsa/industry-leaders-announce-phr-model.html Industry Leaders announce personal health record model; collaborate with consumers to speed adoption

http://www.vivici.wordpress.com/2007/10/26/a-personal-health-care-record-phr-based-on-international-open-standards-facilitates-true-patient-empowerment A personal health care record phr based on international open standards true patient empowerment

PHRs in Underserved or Underrepresented Communities

California MiVIA™

MiVIA™ was launched in 2003 as a personal health record for migrant and seasonal workers in Sonoma Valley, California. Today MiVIA™ provides an electronic record for several thousand people and their families across the country. https://www.mivia.org/

Click to see MiVIA™ featured in the television series, Healthcare 360: Monitoring American Medicine https://www.mivia.org/PressMain.aspx

9. Information technology enabling consumer empowerment and personal health records (e.g., Microsoft Personal Health Vault integrating device data into PHR - Susan CB; Google/Cleveland Clinic - Rita Z - allow patients to untether their PHR; ubiquitous kiosk stations in libraries, Wal-marts, etc. - Susan)

*technology strategies to make PHR portable (Google/CC)

http://www.mydigitallife.info/2008/02/23/google-in-heath-management-service/

Life Record EMR On the iPhone http://emr.liferecord.com/emr/index.html

Emergency Data: MyVitalData http://www.vitaldatatech.com/sol_myvitaldata.htm

Employer Sponsored PHRs (e.g., Wal-Mart; Google; Microsoft, etc.)

http://www.dossia.org/home

http://www.dossia.org/news/useful_links/1472-6947-7-25.pdf

Report cards, other tools