Vital Records: Vital input for population health measurement
Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National...
-
date post
20-Dec-2015 -
Category
Documents
-
view
213 -
download
0
Transcript of Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National...
![Page 1: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/1.jpg)
Patient Access to Health Information
James J. Cimino, M.D.
Columbia University
Presented to National Committee on Vital and Health Statistics
Chicago, Illinois
July 24, 2002
![Page 2: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/2.jpg)
Overview
• Patient Clinical Information System (PatCIS)
• Myocardial Infarction Health Education Aimed at Rapid Therapy (MI-HEART)
• What we learned
• Standards issues
• Where do we go from here?
![Page 3: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/3.jpg)
Patient Clinical Information System (PatCIS)
• National Information Infrastructure Program (NLM)
• Give patients access to their records
• See what happens
![Page 4: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/4.jpg)
PatCIS Architecture
• Front end to New York Presbyterian Hospital’s Clinical Data Repository
• Address security issues
• No attempt to create “patient view”
• Added educational resources, guidelines and infobuttons
![Page 5: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/5.jpg)
![Page 6: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/6.jpg)
![Page 7: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/7.jpg)
![Page 8: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/8.jpg)
![Page 9: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/9.jpg)
![Page 10: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/10.jpg)
PatCIS Evaluation
• Questionnaires
• Usage Logs
• Interviews
![Page 11: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/11.jpg)
PatCIS Results
• 13 patients followed for 36 months (223 patient months)
• Technical barriers not an issue
![Page 12: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/12.jpg)
1831
83
10 67317 1013
53 2
Data Review Infobutons Data Entry Education Disclaimer
Help e-mail Newsgroups Advice Comments
![Page 13: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/13.jpg)
35
36
81
151896
3035
Laboratory Radiology Pathology Microbiology
Other Reports Vital Signs Diabetes
![Page 14: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/14.jpg)
PatCIS Results• 13 patients followed for 36 months (223 patient
months)• Technical barriers not an issue
• Overwhelming usage was lab results
• Little interest in educational materials
• Improved patients’ understanding of their conditions
• Improved doctor-patient interactions
![Page 15: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/15.jpg)
MI-HEART
• National Heart Attack Alert Program (NLM and NHLBI)
• Decrease time from onset of MI symptoms to calling 911
• Explore use of Web as educational medium
• Explore use of clinical data for customization
![Page 16: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/16.jpg)
MI-HEART Protocol• Three patient groups
– Control: standard paper-based materials– Non-tailored: standard Web-based messages– Tailored: customized Web-based messages
• On-line questionnaires– Baseline– One month– Three months
• Examine– Risk assessment– Knowledge– Self efficancy
![Page 17: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/17.jpg)
![Page 18: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/18.jpg)
![Page 19: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/19.jpg)
![Page 20: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/20.jpg)
![Page 21: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/21.jpg)
![Page 22: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/22.jpg)
![Page 23: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/23.jpg)
![Page 24: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/24.jpg)
![Page 25: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/25.jpg)
![Page 26: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/26.jpg)
MI-HEART Results
• 120+ subjects
• Data collection and analysis ongoing
• Web-based groups improved on all scores compared to paper-based
• Tailored group showed sustained improvement compared to other groups
![Page 27: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/27.jpg)
What We Learned
• Patients can handle the technology
• Patients want their results
• Patients want to collaborate with physicians
• EMR+Web can be an effective educational medium
![Page 28: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/28.jpg)
Standards Issues
• Browsers
• Patient identifiers
• Terminology for patient data
• Access to high quality resources
• Guideline structure
![Page 29: Patient Access to Health Information James J. Cimino, M.D. Columbia University Presented to National Committee on Vital and Health Statistics Chicago,](https://reader030.fdocuments.in/reader030/viewer/2022032704/56649d4d5503460f94a2cd2a/html5/thumbnails/29.jpg)
Where do we go from here?• Identify agenda for involving patients• Infrastucture
– Standards– Identification– Confidentiality– Access– Education
• Data• Content