PHR and Microsoft Healthvault Insights

This year, Microsoft Healthvault awoke from a fitful slumber and released “HealthVault Insights.”

Insights is a major step that includes hooks to Microsoft Cortana in order to provide some degree of analytics and access to diary etc. The most significant component in Insights is the ability of participating health care professionals (HCP) to build a Care Plan in their part of the application, and push it to the user (patient).

That is a pretty major step, because instead of a dim and clouded memory of the encounter to rely on, the patient now has an electronic record to work with. The record might involve excercise targets, dietary objectives, or precipitation schedules.

Great so far, and Microsoft deserves applause for taking personal health records (PHR) to the next level.

However, HealthVault developers and I have argued with regard to who should have the ability to initiate a Care Plan. Understandably, Microsoft are physician-centric, and see the Care Plan as starting its existence as the culmination of a medical encounter.

I see this as a workflow mistake.

To my mind, the vast majority of healthcare encounters will begin with a patient seeking an appointment for an injury, illness, or medication change. While it is certainly true that sometimes the physician initiates an encounter for a routine checkup or medication review, this is by far in the minority.

What Healthvault Insights doesn’t allow, is for the patient to initiate a Care Plan and push it to the provider. I believe this is a major gap, given the way most encounters are originated, and the need to enable activated patients to be self-managing.

Allowing the patient to create the Care Plan makes the process more patient-centered, encourages better encounter planning, and makes the patient more responsible for their health management.

The key elements should include:

  • Templates to guide the patient in listing signs and symptoms
  • Guides to help the patient select a tentative chief complaint
  • Diary and PHR hooks to develop a recent medical history of the complaint as a timeline
  • Prompts to help them develop a statement of health goals
  • Listing of their current PHCP or HCPs available with their current insurance
  • Means to push the resulting care plan to the HCP they selected as a care request with preferred dates and times

On receipt of the care request, the HCP could respond with an encounter at the most medically appropriate level of care, whether that is a Care Plan for self-care at home, encounter with a nurse, encounter with a physician, referral to a specialist, etc.

Currently, Microsoft agrees with the concept as I have described it here, but is relying on the HCP or other interested stakeholders to develop the functionality using the Healthvault software development kit. I think this is an unlikely scenario, and that the ability for patients to initiate, build, and push a care plan should be part of the core Insights functionality.

That’s my story, and I’m sticking to it.

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Published by

Matthew Loxton

Healthcare Analyst using Lean Six Sigma, Knowledge Management, & Organizational Learning to improve healthcare http://linkedin.com/in/mloxton

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