Personal Health Records and Personal Medication Records SOS

Personal Health Records and Personal Medication Records SOS Rx Consortium April 7, 2004

Personal health records: Information needed to manage your health

Months Later…

Attributes of Personal Health Information System • • Person controlled Comprehensive Longitudinal Private and secure Accessible from anywhere ‘Break the glass’ function Depends upon an existing national, interconnected infrastructure

Would people use a Personal Health Information System?

Survey results: A personal medication list • • Do people want it? How does interest compare with other features? Which people would use it? How would you target interested market segment?

Respondents wanting PHR features, now or in future

Respondents wanting a personal medication list

Likely first users of medication list

Benefits of medication list: EHI Incentives Report (4/14/04) • Prescription claims history, when made available at the time of an ambulatory care encounter, can also help prescribers become aware of non-compliance issues that otherwise would have gone unnoticed. At Henry Ford Health System, when a 6 month claims history report was attached to a patient’s chart at the time of a clinic visit, a non-compliance problem was detected 30% of the time, compared to 0% detection when the report was not available.

Encouraging medication list • Support single unified medication list, combining information from clinicians, pharmacies, and health plans. Develop standards and actual software to do this, so appropriate persons can work with the patient’s accurate med list. Resolve any privacy and ownership issues necessary for this. • Support patient portals where the patient can see their med regimen (many patients are very confused by frequent changes, and wind up taking duplicate meds or leaving some out), request refills from pharmacies and renewals from clinicians, and propose additions (for non-prescription drugs) and corrections.

Building medication lists: what needs to happen - process? • Early e-prescribing sites need to build initial list from their own practice • From paper chart • From interviewing patient • From accessing claims history • Integrate claims data • Integrate pharmacy dispensing data (PBM, retail) • Acquire patient data (actual use, herbals, OTC, etc)

Building medication lists: what needs to happen - policy? • Common patient identifier (and MD and pharmacist); today, trading partners decide on identity for their transactions but no standards. Too many MD identifiers, none for nurse practitioners or pharmacists. • Encourage adoption of standards: Rx. Norm (a std vocabulary to identify drugs), NDF-RT (a taxonomy to classify drugs into groups and permit decision support to work) • Encourage messaging standards: NCPDP SCRIPT, HL-7 - how do you ask for a refill or correct an error? • Standardize instructions for taking drugs (I. e. , TID 3 x daily when exactly? ) • Define common core data set