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.

Upcoming #MEQAPI Chats

Here is the schedule for forthcoming #MEQAPI chats

  • Aug 3 “Improving Joy in Work” – based on IHI Whitepaper and related to physician burnout
  • Aug 10 “3D Printing in Healthcare” with the indomitable @wareflo
  • Aug 17 “Healthcare Star Ratings”
  • Aug 24 “Workplace Safety”
  • Aug 31 “Veterans Health, Triumphs and Opportunities” with @nxtstop1 and @VATBIdoc

Unscheduled but planned:

Upcoming #MEQAPI Chats

Here is the schedule for the next four weeks:

  • July 6 “ETOH & Fireworks” inviting all our Emergency Medicine and Primary Care collegues to relate their insights of 4th of July combination of booze and gunpowder
  • July 13 “End of Life Planning” with Andrea J. Wilson of Blue Faery  @BlueFaeryLiver
  • July 20 “Physician Wellness & the Quadruple Aim” with @nxtstop1 and @subatomicdoc #crazysocks4docs
  • July 27 “Opioid Epidemic” – now the leading cause of death in <55 yr old white males

#MEQAPI Tweetchat Jan 19 2017

Next tweetchat: Thursday January 19th, 2017 3:00-4:00 PM ET

MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The format will follow a similar structure to the famous and well-loved examples of #HITSM, #HCLDR, and #IrishMed – guest moderators will pose 4-6 topics in sequence, aimed at igniting discussion and interaction.

Three healthcare domains in which we might want to pay close attention are Care Policies, Care technologies, and care flow.

The following topics will be posed this week related to Healthcare Policy and how quality can be seen in terms of risks, issues, and opportunities:

  1. How should governmental or organizational health policies be subjected to Monitoring & Evaluation
  2. What policies fail at least one element of Safety, Timely, Efficiency, Effectiveness, Equitability, Patient Centered
  3. How should we monitor cost, morbidity, and mortality effects of a policy or law
  4. What role do the medical NGOs, journals, and professional bodies play in healthcare improvement
  5. How can providers and patients drive improvements in healthcare policy

 

#MEQAPI Tweetchat: Jan 12 2017

When: Thursday January 12, 15:00-16:00 ET

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare quality, and will include everyone from administrators to zoologists, and include physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.

The format will follow a similar structure to the famous and well-loved examples of #HITSM, #HCLDR, and #IrishMed – guest moderators will pose 4-6 topics in sequence, aimed at igniting discussion and interaction.

The following topics will be posed:

T1 What role should the government or international bodies play in healthcare improvement?

T2 What role should the public, and especially patients, play in process or quality improvement?

T3 In what areas of healthcare do you see the biggest need or opportunity for quality improvement?

T4 What quality failure have you personally experienced in healthcare, and what was the outcome?

T5 Do you feel comfortable reporting a quality issue, and if not, why not?