WO2009132434A1 - Method, system, and computer program for providing patient-driven electronic health records - Google Patents

Method, system, and computer program for providing patient-driven electronic health records

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Publication number
WO2009132434A1
WO2009132434A1 PCT/CA2009/000558 CA2009000558W WO2009132434A1 WO 2009132434 A1 WO2009132434 A1 WO 2009132434A1 CA 2009000558 W CA2009000558 W CA 2009000558W WO 2009132434 A1 WO2009132434 A1 WO 2009132434A1
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WO
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Application
Patent type
Prior art keywords
health
patient
care
information
data
Prior art date
Application number
PCT/CA2009/000558
Other languages
French (fr)
Inventor
Kenneth Percy Caskenette
Original Assignee
Kenneth Percy Caskenette
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

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Classifications

    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records

Abstract

The present invention relates to patent-driven personal health records. The personal health records are controlled and contributed to by patients. Patients control access to the personal health records by providing access to select health care providers. The select health care providers can also contribute to the personal health record by manually doing so or by contributing to other systems that are associated with the personal health record system. The personal health record enables a patient to be educated about their own medical history and enables a patient to discuss health issues with health care providers.

Description

Method, System, and Computer Program for Providing Patient-Driven Electronic Health Records

Field of the Invention

The present invention relates to electronic health records. The present invention more specifically relates to personal health records controlled and distributed by individual patients.

Background to the Invention

Globally there has been much written about electronic health records and specifically about a personal health record (PHR). Most of the literature relates to electronic health records (EHRs) driven by provider- based systems as opposed to one that is owned and controlled by the health care consumer/ citizen/patient (hereinafter, "patient"). Please also see further below for further information on the use of the term "patient" in this disclosure.

These provider-driven solutions generally address the needs of the individual institution rather than the patient who is being treated. A significant portion of health care takes place within the home (e.g. self care domiciliary care), not in a single doctor's office or hospital, or over fragmented health care providers delivering the majority of care over the patient's lifetime (e.g. chiropractors, dentists, naturopaths, etc.).

The media discusses daily the delivery of health care and how an Internet-based Electronic Health Record (EHR) and an Electronic Medical Record (EMR) will reduce costs and improve care within the "universal health care system". Care providers and agencies developing EHR systems require substantial monies (typically, in the billions of dollars) to make their systems more effective.

Current EHR development generally consists of four basic components:

1. Demographic (insurance & statistical) information;

2. Laboratory reporting;

3. Drug information; and

4. Diagnostic imaging reporting.

These developers are silo based and while referring among themselves they work as independent businesses providing information to each other. However, the patient is not included in this loop as patients are seen as ill informed and varying degrees of information filtration is administered by their physician caregivers. Also, the physician caregivers work separately and apart from other caregivers such as dentists, chiropractors and the like. Typically, if a patient is more informed he or she would at least make better decisions on his or her own care, and furthermore would better be able to provide relevant information to health care providers and in some cases play a role in disseminating relevant health care information to providers who do not have access to particular information.

An indication of patients trying to understand their own health is the results of Internet searches done by individuals globally: in one study it was found that of the 6.4 billion searches done monthly, health searches equal 4.8% or 218 million done by individuals.

Currently, implementations of EHRs typically fall into two categories:

1. Hospitals, Pharmacies, Diagnostic testing records: the focus is upon the clinical and professional care givers while providing little personal health care information to the patient. Major investments are focused into the hospital system that is best at providing intensive care at the beginning of life and the end of life. For most patients, however, the majority of care and consultation throughout life is through family physicians and other caregivers.

2. Physicians Records: typically, very few physicians have an automated electronic medical record (EMR). The rest rely upon paper records that sit in file folders without rapid access. Further, the majority of patients complain that they seldom get results of tests, are anxious about their last visit with the physician, and never really know what the next steps in their care are. Furthermore, physicians are under significant time pressures and therefore have little time to review records and information in preparation or during patient visits, and therefore there is a need for improving their access to information and the organization of this information to enable better use of physician time.

Furthermore, as a result of the above two distinct categories of health records, information is not shared in one coordinated file and could result in incomplete critical data not being reviewed by the professional practitioner.

Furthermore, natural disasters (such as tornadoes, tsunamis, fires, ice storms, hurricanes, earthquakes and volcanoes) or terrorists attacks highlight the lack of individual health information infrastructure should one strike in an area. Fortunately, these large-scale disasters are rare, however there is evidence that natural disasters are increasing. This risk could be addressed in part by decentralizing the control of health information by enabling patients to administer in a secure manner their requirements for health information.

Most levels of government (federal, provincial/state, regional, and local) have encouraged the adoption of EHRs. These discussions have not given a PHR the level of attention that it deserves as the potential for savings in the health system by having patients taking responsibility for their own health is substantial. The EHR system's function is to serve the professionals; a PHR system captures data entered by individuals and provides information related to each individual.

Therefore, what is needed is a system whereby a PHR is provided in such a way as to enable patients to access and control their individual personal health information. What is also required is a means whereby a health care professional can contribute information to a PHR.

Summary of the Invention

In one aspect of the present invention, a method for providing patient driven personal health records is provided, the method comprising: (a) providing a health record associated with a patient; (b) enabling the patient to contribute data to the personal health record; (c) enabling the patient to control access to the personal health record to one or more health care providers; (d) enabling the one or more health care providers to contribute data to the personal health record; and (e) enabling the patient and the one or more health care providers to access the updated personal health record.

In another aspect of the present invention, a system for providing patient driven personal health records is provided, the system comprising: (a) a health record associated with a patient; (b) a means whereby the patient contributes data to the personal health record; (c) a means whereby the patient controls access to the personal health record to one or more health care providers; (d) a means whereby the one or more health care providers contribute data to the personal health record; and (e) a means whereby the patient and the one or more health care providers access the updated personal health record.

In a further aspect of the present invention, a computer program for providing patient driven personal health records is provided, the computer program comprising computer instructions, which when loaded on a computer are operable to provide an application defining an interface that enables a patient to initiate the computer to provide a patient driven health record by: (a) providing a health record associated with patient; (b) enabling the patient to contribute data to the personal health record; (c) enabling the patient to control access to the personal health record to one or more health care providers; (d) enabling the one or more health care providers to contribute data to the personal health record; and (e) enabling the patient and the one or more health care providers to access the updated personal health record.

Brief Description of the Drawings

FIG. 1 illustrates the system of the present invention, in one aspect thereof.

FIG. 2 illustrates the method of the present invention, in one aspect thereof.

Detailed Description of the Invention

The present invention discloses a method, system and computer program providing a patient driven PHR.

It should be understood that the term "patient" is used in a general sense in this disclosure to signify an individual who is associated with their health information. A "patient" need not be under the supervision of a physician as this term is used in this disclosure. The "patient" may be under the care of health care providers that where we would not normally infer the existence of a health care provider / patient relationship. For example, an individual who sees a massage therapist or herbalist is not normally referred to as a "patient". Nonetheless health information of value could be generated in each of these cases, and the term "patient" as used in this disclosure would extend to these situations. Also, it is possible that a "patient" as this term is used in this disclosure may never have had an illness or other cause to engage with the health care system; nonetheless there would be value in accumulating health information as enabled by this invention.

The system may be administered by a third party (or delegate) and accessible to patients and health care providers (where the providers have been given access by the patient). The delegate may also optionally employ a physician or other health care professional to assist patients using the system in organizing their information. The physician or other health care professional may also act as a liaison to health care providers when the patient is finding it difficult to obtain appropriate contributions to the PHR from the provider.

A patient may be provided with a range of tools enabling the patient to direct collection of health related information into the PHR and to add information directly to the PHR on an ongoing basis. In accordance with these tools, the patient may be provided with a means for granting access to select health care practitioners in order to allow the practitioners to contribute information to the PHR. Thus, the patient may be assured of a high degree of completeness because all providers of information are included and controlled not by a delegate, but by the patient himself or herself.

It should be understood that the present invention enables the timely and efficient collection of health information from multiple health care providers. It has been observed that there is a reluctance sometimes in health care providers to provide access to patients to their health records after the fact for example because of fear of litigation. The present system also alleviates this obstacle to assembly of such health information.

Electronic Personal Health Record

In one aspect of the invention, it provides a universally accessible, layperson comprehensible, lifelong tool for managing individuals' health information, promoting health maintenance and assisting with disease management, based upon a common data set of electronic health information and tools. The personal health record is owned, managed, and shared by the individual or their legal proxy(s) and is protected and secure to protect the privacy and confidentially of the personal health information. The electronic personal health record created in accordance with the present invention may be a legal document and subject to the legal regulations of individual country, states, and legislative requirements of where the data is hosted.

In another aspect of the present invention, a central repository of all data for an individual patient is provided, which may be kept in a single location, similar to a financial bank account. The links to the patient's caregivers are interfaced to the central repository as identified by the individual patients. At each encounter of care the information from each care provider is either manually or automatically delivered to the web central repository, the PHR utilizing the unique identifiers to immediately deposit the information into the patient's PHR thereby ensuring that the PHR is always up-to-date and available. With the use of the automatic messaging, the patient is informed of any new information and can provide this to their other (multiple) caregivers allowing the patient to provide informed consent and a degree of understanding of their care being delivered.

The present invention, in one aspect thereof, provides a system for organizing patient information in a PHR. The system consists of a computer, linked to a computer program that includes instructions operable on the computer to provide the functionality described herein. The PHR may be a repository for individual patients' data that includes care delivered by many health care providers that can be shared with all of the patient's health care providers to give decision-support capabilities far in excess of the physician, hospital, pharmacy, nursing home, current paper, hospital information systems (HIS), EMR or EHR silo-based systems in place today. Optimal care is currently hampered by this fragmented, silo-based system of storing and retrieving essential patient data. Furthermore, the system may provide integrated tools allowing providers to automatically deliver health information in health industry standards (e.g. ASCII, HL7, CDA, CCR, CCD, PDF Healthcare, XML code).

The present invention, in another aspect thereof, provides a system enabling patients to access and control their individual personal health information via a PHR. The system may be an electronic application through which individual patients can create, assess, manage and share their health information, and through which others authorized by the patient (for example, delegates including caregivers or health care providers including medical practitioners) may create information and deliver it to the individual patient's PHR in a private, secure and confidential environment.

A web based PHR access interface may be provided, whereby a patient may access his or her PHR, and may provide access to his or her PHR to select health care providers. The health care providers may contribute to the patient's PHR by manually adding information or via an interface between the system of the present invention, and systems used by the health care providers. These may be systems such as hospital health records; regional EHRs; physician EMRs; foreign hospital systems; or non-traditional health providers such as community access centre systems, long term care servers, diagnostic image EMRs, walk in clinic EMRs, pharmacy EMRs, and lab EMRs. The system of the present invention may be operable to associate with these systems where the other systems operate on known standards, for example those health industry standards identified above, or other systems known and used by those skilled in the art. Conversion among standards may be provided by the converter systems in the present invention.

As best illustrated in FIG. 1 , the system, in one implementation thereof, may comprise at least one web server 101 comprising or linked to an interface utility 103 and a personal health record utility 105. The web server 101 may also be linked to a storage means 107, for example a database, for storing a plurality of personal health records. The interface utility 103 may provide to patients and their delegates access to system features of the present invention as more fully described herein.

The personal health record utility 105 may enable patients 109, their delegates 111 and designated health care providers 113 to view, modify, contribute to, export and share their individual personal health records. The personal health record utility may also enable patients 109 or their delegates 111 to set medication reminder alerts. Delegates 111 may be, for example, health professionals, caregivers or relatives of the patient who oversee the patient's health care. The personal health records or portions thereof may, for example, be shared with health care providers 113 who, after assessing the patient, may contribute to the report using the personal health record utility 105.

In use, for example, as shown in FIG. 2, a patient may obtain 201 their personal health record. The patient may optionally choose to enable one or more delegates to have access rights 203, for example viewing, management or contribution rights, to the personal health record. If so, the patient may designate a delegate 205 and assign the desired rights 207, repeating this process for each delegate.

Once delegates, if any, have been assigned, the patient or its delegates, as the case may be, may select information 209 from the personal health record to be shared with one or more health care providers. For example, information related to a particular ailment may be exported in advance of treatment by a health care provider related to that ailment. The information to be exported may be restricted, as chosen by the patient or its delegates, based on the amount of disclosure desired. The selected information may be exported either to a record that is a subset of the personal health record, or to a format usable by the health care provider, for example those health industry standards previously identified, or any other desirable or practical format.

The exported information may then be shared 213 with the health care provider by enabling the health care provider to access the information either using the personal health record utility or by sending a copy of the selected information, for example physically or by electronic means as more fully described below, to the health care provider. The health care provider may then assess the patient and, also using the personal health record utility, contribute 215 its findings to the personal health record, which may then be appended to the personal health record 217. Access to the health record by the health care provider may or may not be terminated at that time, as desired by the patient or its delegates.

It should be understood that the present invention is operable to accept electronic data using unique identifiers from multiple diagnostic and individual institutions, companies, caregivers and health care providers in a secure confidential way, ensuring that the information is current. The invention may provide, in accordance with a particular implementation thereof, two portals for data delivery: one for the patient, another for professional certified caregivers or health care providers. This is to ensure that data from caregivers and health care providers is maintained in its original format and cannot be altered without authenticating the caregiver or health care provider to the system of the present invention.

This system may overcome the significant technological hurdles that current silo-based caregivers use to communicate by allowing for the information supplied by these various caregivers to be converted into a standard digital document format (such as portable document format, or PDF™, which is known to those skilled in the art) and stored in one central electronic record under the control and direction of the individual patient. The PHR may be able to accept information currently available on paper, in stand alone computers, clinic and pharmacy systems as well as information from multiple hospital information systems, lab systems, etc.

This solution may be provided as a secure internet-based system that allows a patient to access and coordinate his or her lifelong health information in order to make informed health decisions. The patient may own and manage the information within the PHR, including information from his or her approved healthcare providers.

The present invention also discloses a method of document delivery in relation to PHRs. PHRs may be disseminated by a plurality of methods including a web accessible portal and by a transportable storage medium, such as USB memory key, memory card, or smart card.

The PHR of the present invention overcomes many of the hurdles faced by previously disclosed EHRs. For example, the PHR of the present invention is especially useful to those patients who do not have a family physician, patients whose occupations have them traveling far away from their primary care providers (such as pilots, long distance truck drivers, bus drivers), or as part of their business, or patients on vacation. The PHR helps patients to concisely explain their health problems when they meet with health care providers because they have documented symptoms as they occur. This, for example, addresses one of the most common issues for current elderly patients who are intimidated by health professionals and become tongue tied when meeting with them. It also can provide consent information for a personal care giver (e.g. family members) to assist in the care of their elderly parents from a distance. In addition, it can help document information that may be useful when filing health insurance claims. It should be understood that in one aspect of the present invention, the system is operable to communicate with a plurality of systems that are operable to generate or provide health information, such information being optionally in multiple formats. This resolves the issue of significant delay and cost in building in access to specific types of health information because of the need to acquire or integrate different information systems, which can result in particular challenges given concerns around information security. In one aspect of the invention a novel health information architecture is contemplated that is built on a one-to-many deployment provided in a manner that is known.

Access System

The system of the present invention may be provided as a secure web-based, portable, PHR access system. Ownership of the record changes from one that is distributed among the various health care providers that a patient rarely sees in their lifetime to one with a single file or set of files that is accessible from anywhere in the world under the ownership and control of the patient who allows access to their care providers.

A patient may enter and record important health events, results of diagnostic testing prescribing medications, and visits to multiple caregivers. For example, a patient or a medical care provider granted access by the patient may enter results of laboratory tests. Alternatively, a patient may enter data related to care provided by other caregivers (physiotherapists, chiropractors, dentists, etc.), or data regarding off- the-shelf medications taken by the patient. Such information would typically not be available using traditional EHRs, and may represent valuable health information.

All data may be entered using free text entry fields, text selection menus, uploading files directly to the access system, or any other method of contributing information using a web access system.

The system may further provide for the entry of exercise, diet and physical fitness information to be added for an overall picture that allows the patient, with their health care providers, to see a complete picture of their health situation. It is unique in that it may give the patient the tools to take responsibility for his or her health and become part of his or her care team. It allows different professionals to add their diagnoses and then other professionals can view a holistic person.

The system may serve as more than a repository of an individual's health information. The system may also assist in a patient's understanding of health information. There may be tools provided to assist a patient to collect information regarding interpretation and current literature in a plurality of categories, which may include: media articles, journals, medical articles, Internet search engines, medication organizers, medication encyclopedias, dictionaries, etc. The system may be enabled to collect information from any electronic source and provide a means for the patient to add the information to the PHR.

A patient may choose to collect information using any categorization he or she chooses, such as by treatment, symptom, condition, diagnoses, tests, risks, causes, alternative medicines, etc. The collected information may enable the individual to evaluate, and consult with his or her health care providers to verify, its validity. The patient may also then understand how a plan of action will assist him or her for his or her future health considerations. Furthermore, the information added to the PHR by the patient may be of benefit to the health care provider, since these providers may not always be fully up-to-date on developments in the field.

A patient may add collected information to the PHR either by incorporation into the PHR, or as a link to the original content, accessible from within the PHR. The information may also be printed or converted to the standard digital document format for storage in the system, and optionally added to a transportable storage medium for discussions with health care providers. The transportable storage medium is described more fully below. Collected information may be reviewed by a health care provider either via a web site providing access to a PHR, on the transportable storage medium, or using a paper version of the document to ensure understanding of the health issue.

The Electronic Medical Record and The Personal Health Record

The PHR may be associated with an electronic medical record (EMR). EMRs are typically controlled and maintained by physicians. The present invention, in one aspect thereof, may enable a physician to contribute to the PHR using data stored in the EMR. The physician may first be required to obtain the permission of the patient to access and contribute to the PHR.

The EMR and PHR may be stored as a web accessible medical record. The patient may grant access to the PHR to the physician using a secure web site. The system of the present invention may provide all health care providers with a method to manually or automatically (via a separate portal) insert patient information in the PHR as they deliver care to a patient and update their respective EMR. This may allow for a family physician to have access to information not typically seen by them, corresponding to when a patient goes to a walk-in clinic; sees other professionals; takes off-the-shelf medications, vitamins and other self-administered treatments; and view any other information such as training the patient has been undergoing; that each may give clues to a problem not believed to be important by the patient.

Additionally, this may provide the patient the ability to communicate with his or her health care providers to: request prescription refills and appointments; see who has accessed the PHR (e.g. an audit report); create various electronic commerce requests such as prescription fulfillment at a retail or Internet pharmacy; perform highly personalized and tailored information retrieval for a patient based on their true diagnoses and medications or interests; and perform automated claims submission and coordination.

In another aspect of the invention, the PHR includes or is linked to a reminder system for appointments, reorders for medications and alerts of new diagnostic and health reports as they are received at the web PHR.

The PHR may be used by the patient as a source for broad medical knowledge-based information of the patients' medical information over their lifetime by providing the diverse care providers with access to their information.

As a result of the above methods of usage, a PHR may enable exchange, understanding, and reasoning about personal experiences with disease and the health care system, as a secondary information process. As a result, patients may be directed to specific forms of communication (such as chat rooms and message boards) where patients and caregivers may debate and exchange information regarding their personal experiences with disease and health care.

Content

The medical content may be regarded as the most important aspect of the PHR. Both the breadth (the total number of different types of data that are captured) and the depth (the amount of detail within each data type) are crucial.

Some data types may include: current medical problems; current medications; known allergies along with the reaction; past medical history; family history of disease; vaccination type and last date administered; demographic data to allow unambiguous identification of the patient; name and contact information for primary care physician; and recent results of common diagnostic imaging and laboratory tests. Another key concept regarding the medical content may be the manner in which it is collected. The medical content can be captured in two distinct ways: data entry by patient and automated data capture from other systems.

Data may be entered by a patient or their trusted approved medical professionals. The common and easy method of entry may be by free text data entry fields. In order to enable the system to use such data in any future computations, data must be entered in such a way that the responses can be matched to preexisting, known data elements (such as by using industry-standard coding such as HL7 or XML code). Therefore, items to be entered may be chosen from a list of elements, or data entered in free text fields can be compared to known data elements and any ambiguous entries can be fed back to the user in a short list for final selection. This is accomplished by using established standards for data elements as outlined in relevant guides (such as the HL7 and PDF Health guidelines).

A means for identifying the contributor of information may be provided. All entries may be logged by the system of any individual providing the content and only that individual may be permitted to edit the individual entry. The data files may be defined by the standards (such as PDF healthcare) for data entry to ensure compatibility to other standards (such as XML code) for delivery to other care providers. The intent may be to provide a tool for the patient to provide to their caregivers the most complete record that they can accumulate. The use of such lists works best when the entire universe of data items from which the item will be chosen is relatively small.

Data may also be entered through automated data captured at the source of encounter/visit (e.g. during filling of pharmacy prescriptions). As each encounter occurs (such as issuing a prescription) data may be sent to the system using an encrypted continuity of care record (CCR) to populate the medications fields using applicable (national) drug standards. The CCR standard is known to those skilled in the art.

Another encounter type may be to automatically capture clinical information from HIS or EHR of an emergency or clinic visit that can include diagnostic reports and clinical notes (discharge summary) in a CCR to other EMRs.

The present invention may provide tools to enable these automated data captures. The tools may be operable at the site of the encounter. They may poll the HIS for current information and results, and either report at the time of discharge or print information at the encounter site. This data, used to create a printed document (using HL7 or ASCII standards) or create reports within an HIS system, may be captured by the tools and then converted to a standard coding (XML or PDF) depending upon the data stream being read. The coding may be wrapped in a CCR, sent digitally to the PHR (which may be within a VPN), and then added to the individual's PHR depending upon the type of information within the CCR.

The data may also be associated with identification information allowing for the contributor of each piece of data to be identified. This may be important for a health care practitioner to assess the credibility and relevance of the information.

Adding Historical Medical Data

Currently, the majority of medical data is stored in paper form. The present invention includes a means by which to import this data into PHRs. As long as basic data is provided, paper forms may be translated by the system of the present invention. Currently, bar coding and providing demographic information is a common method of electronically reading even handwritten forms.

A tool may print documents at the point of need or output to create an image in a standard format (such as PDF/A). This process may deliver documents with demographic information rather than using labels or blank forms. These printed documents or images are functional documents with complete human readable demographics including functional bar codes that will index future scanning or input into any EHR.

Barcodes may contain a limited amount of data. The bar coded data required for indexing could be as follows: encounter number, form number including version, provincial health number (PHN) (or equivalent in other jurisdictions if applicable), regional unique number, and unique organization identifier. Barcodes can be used to reliably link paper documents to electronic workflow. Users may print or fax a digital document (such as PDF) that contains a barcode. That printed or faxed paper document can then be transmitted to another party, who can then scan in the barcode and obtain the information back into electronic format.

Healthcare includes many workflows, which rely on paper and fax. Barcodes provide the ability to incorporate these paper workflows into more accurate and automated electronic workflows. Simple, static barcodes place few if any requirements on an end user. Implementers of more complex 2-D or dynamic barcode based systems should ensure that all digital document viewers support the required fonts and forms capabilities needed in these scenarios.

Access to Data Various methods may be provided for accessing data once it has been entered into a PHR. For example, health care providers may request, from the delegate, a copy of the record via phone. Upon successful authentication (such as by use of a personal identification number, or PIN), the administrator may release a copy to be emailed or faxed to the health care provider. Thus the on-line PHR becomes an additional source of complete information on a patient especially in an emergency. By allowing health care providers (approved by the patient) to interact with the record using authentication, the PHR becomes a central point of communication between the patient and health care providers. By only allowing the patient to create and view the record via the web, the system is valuable to the patient. By simply providing a standard digital document format output to the record, the citizen can take a document or hard copies along to their appointments with care givers anywhere in the world.

The transportable storage medium (such as a USB drive, memory card, smart card, etc.) may be password protected and be associated with a contact method (such as telephone number or email address) to access password information on a 24 x 7 basis. To authenticate in order to retrieve a password, key information may be asked for by the delegate. Once given, the documentation may be released to the health care provider and the password to the transportable storage medium may be given. Alternately, in the case of a patient being incapacitated then the health care provider may be required to ask for a return contact in order to verify the callers credentials.

The system of the present invention may also include a computer program that may convert automated code input data into a human readable format to be placed onto the transportable storage medium (or in print) to be taken with the citizen when they are visiting any another health care professional. The benefit of the transportable storage medium is that it may be scanned for viruses prior to use by a hospital or clinician. Furthermore, many hospitals or clinicians may not desire to access the Internet version of the PHR, in which case the transportable storage medium may prove beneficial.

Privacy

Medical information is regarded as highly personal. The website of the present invention may be provided without "cookies", which are tracking software and are known to those skilled in the art. Thus, each patient may be required to enter credentials in a log-in screen each time they wish to access the PHR. Similarly, health care professionals must enter credentials in a log-in screen each time they wish to access the PHR or EMR.

Revenue Models Various revenue models may be provided with the system of the present invention.

One possible revenue stream may be provided using sponsors of the system. Sponsors may provide tools (such as USB devices) for patients to deliver PHRs to health care professionals. These sponsors may be identified as sponsors of the system on the log in screen and through having the individuals go to the sponsors locations to get the tool and documents created and sent to the system.

Contextual advertising may also be provided. It may be desired to limit contextual advertising such that it is not considered an invasion of patients' privacy.

One aspect of the present invention is that it provides a method and system that also enables the funding for a PHR. Many prior art solutions directed in a general way to electronic health records see institutions such as hospitals or government bodies as the entity that will build and manage the centralized sites required to enable the use of electronic health records. The costs associated with implementation of such a solution are prohibitive. Patient participation in the process, and finding alternate sources of revenue to fund the infrastructure and other costs are an important part of deployment of the solution described in this invention.

One way to generate this revenue is the use of local community blog and video sites. The Internet fosters new groups of people who are eager to report on local issues and engage in social networking that has a local focus. The local businesses cannot afford to compete on the national basis and therefore use local newspapers, whether free or based on paid subscriptions. The newspaper industry is experiencing financial difficulty, yet services like YouTube™ and Metro News™ are thriving with local bloggers, writers photographers providing videos and then blogging the things they see and think is important. In some ways the creation and management of a central repository is a local issue, linking patients in a geographic locale with their health care providers in their area. One possible revenue source is from local businesses who may seek a way to increase their exposure to the local community. This can be demonstrated from local initiatives such a business improvement areas and the like.

The PHR may be the focal tool to attract interested users in each community to one or more websites, and generate revenue based on monetization of such traffic, in a manner that is known. Businesses may advertise on the website and provide electronic "coupons" and "tokens" in connection with promotions or loyalty programs that may be linked to the websites. The one or more websites may be associated with other local media including newspapers, flyers and the like. The present invention also contemplates linking to the PHR technology various social networking technologies and processes, for example, to enable users to share experience regarding the collection and management of health information. This further strengthens community creation and the value of the resulting community.

The present invention provides tools for administering information that average consumers are very interested in, and thus enables to bring to online sites individuals who may otherwise use the Internet in a limited way. The ability to appoint delegates to manage data generally results in the delegator beginning to learn how to use the technology from the delegatee over time. The present invention enables connection of communities in a unique way and also to generate visibility in connection with an important demographic group, namely the over fifty-five population who in most of the developed world represents that largest segment of the population.

Hospitals and the Health Clinical Care Communication Community

The present invention provides benefits that may also draw upon cooperation with hospitals and health clinics. Management of health care institutions and businesses are likely to realize the health benefits and cost savings that can be realized by operation of the invention, and collaboration with such entities will likely permit improvement of the ease with which information can be collected and shared by enabling integration of the technology described, and related processes, with technology and processes used in the health care sector. Furthermore, the present invention acts as a catalyst for connecting the health care sector with concerned citizens in the local communities, and closer integration in this regard leads to improvements in health care delivery overall.

This gives us a voice at the table that our small incremental savings will be seen as ways for the hospital to implement change that the community and their frontline teams want. This will result in giving us a voice at the senior decision maker ear.

Cost savings due to elimination and automation of paper forms through reduced time and material costs can be very significant. Automation can an also results in reduction of errors and creation of enhanced electronic health information that can be submitted to data mining and other techniques to improve disease prevention and other aspects of health care improvement. It should be understood that the revenue models described can ensure that operation of the applications discussed, and providing the necessary hardware, software and integration can covered by the revenue sources discussed.

The primary revenues for the system described can be generated through:

1. Revenue from hospitals as the system described would provide without capital investment technologies and solutions for which significant capital outlays are now required by hospital to obtain similar functionality.

2. Fees paid by healthcare providers based on their number of transactions.

3. The use of linked web sites (or pages) that provide information entered by individuals on the type of care, or to review care given at a particular facility (i.e. emergency department).

4. Linked web pages (sites) with local content for small local businesses in each of over 3,000 towns & villages.

5. Referral site for location of services needed by individuals (location of walk in clinics; where to get surgical procedures done faster than at a local site; review of different outcomes from diverse care givers).

6. Health care provider clients pay to the operator of the system described for all consumables that are used for the delivery of information after the elimination of the paper forms, print shop, expensive MFP' s and outsourced printed documents.

7. Consumables for the applications are carbonless paper, armbands, labels and specialized paper products.

8. Health associations utilizing the services described as a fundraising tool.

9. As needed consulting fees to identify and implement process improvement opportunities.

10. Advertising revenues paid by industry suppliers and other advertisers on a product linked web site.

11. Individual communities (see 4 above) may decide to fund specific improvements and this could be a method of transferring ownership of the central PHR to the individuals. It should be understood that various other extensions and alternate implementations of the present invention are also contemplated. The functionality of the website, and workflow of the described web services, may be expanded and enhanced to incorporate new platforms, complementary technologies, use of wireless devices, expanded analytics, integration of systems, processes or data with third party systems etc. All of such extensions and implementations fall within the scope of the present invention.

Claims

Claims
1. A method for providing patient driven personal health records characterized in that the method comprises:
a. providing a health record associated with a patient;
b. enabling the patient to contribute data to the personal health record;
c. enabling the patient to control access to the personal health record to one or more health care providers;
d. enabling the one or more health care providers to contribute data to the personal health record; and
e. enabling the patient and the one or more health care providers to access the updated personal health record.
2. The method of claim 1 , wherein the data is health data associated with the patient.
3. The method of claim 1, characterized in that it comprises the further step of the patient transferring the personal health record to a transportable medium.
4. The method of claim 3, wherein the transportable medium is paper.
5. The method of claim 3, wherein the transportable medium is a digital data storage device.
6. The method of claim 5, wherein the transportable medium is a USB memory device.
7. The method of claim 1, wherein the one or more health care providers contribute data to the personal health record by manually contributing to an electronic medical record, the electronic medical record operable to associate and transmit data to the personal health record.
8. The method of claim 1, characterized in that it comprises the further step of enabling the patient to perform health related research on the data.
9. The method of claim 8, wherein the research is stored to the personal health record.
10. The method of claim 1, wherein the data includes current medical problems; current medications; known allergies along with the reaction; past medical history; family history of disease; vaccination type and last date administered; demographic data to allow unambiguous identification of the patient; name and contact information for primary care physician; recent results of common diagnostic imaging and laboratory tests; and exercise data.
11. A computer system for providing patient driven personal health records, characterized in that the system comprises a computer, the computer being linked to a database and to a computer program, such that the computer is operable to:
a. create one or more personal health records associated with a patient;
b. enable the patient to contribute data to the personal health record;
c. enable the patient to control access to the personal health record to one or more health care providers;
d. enable one or more health care providers to contribute data to the personal health record; and
e. enable the patient and the one or more health care providers to access the updated personal health record.
12. The computer system of claim 11, wherein the data is health data associated with the patient.
13. The computer system of claim 11, characterized in that the system further comprises a transportable medium operable to store the personal health record at transferred by the patient.
14. The computer system of claim 13, wherein the transportable medium is paper.
15. The computer system of claim 3, wherein the transportable medium is a digital data storage device.
16. The computer system of claim 15, wherein the transportable medium is a USB memory device.
17. Thecomputer system of claim 11 , wherein the one or more health care providers contribute data to the personal health record by manually contributing to an electronic medical record, the electronic medical record operable to associate and transmit data to the personal health record.
18. The computer system of claim 18, further comprising a means whereby the patient performs health related research on the data.
19. The computer system of claim 19, wherein the research is stored to the personal health record.
20. The computer system of claim 11, wherein the data includes data relating to one or more of current medical problems; current medications; known allergies along with the reaction; past medical history; family history of disease; vaccination type and last date administered; demographic data to allow unambiguous identification of the patient; name and contact information for primary care physician; recent results of common diagnostic imaging and laboratory tests; and exercise data.
21. A computer program for providing patient driven personal health records, the computer program comprising computer instructions, which when loaded on a computer are operable to implement on the computer an application, characterized in that the application defines an interface that enables a patient to initiate the computer to provide a patient driven health record by:
a. providing a health record associated with the patient;
b. enabling the patient to contribute data to the personal health record;
c. enabling the patient to control access to the personal health record to one or more health care providers;
d. enabling the one or more health care providers to contribute data to the personal health record; and
e. enabling the patient and the one or more health care providers to access the updated personal health record.
22. The computer program of claim 21, wherein the computer program is operable to transfer the personal health record to a transportable medium.
PCT/CA2009/000558 2008-04-30 2009-04-30 Method, system, and computer program for providing patient-driven electronic health records WO2009132434A1 (en)

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