PatientSite: Experiences with Shared

Health Records

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PatientSite ProjectPatientSite Project

• Goals:– Patient involvement– Patient access to information– Secure communication

• 2 person-years– 50% planning and infrastructure– 50% programming

• US$ $250,000 to pilot go-live April 2000

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Mail:SecureAutomated routingTask assignment

Services:Prescription refillsAppointment requestsReferralsView bill

Records:SecureVisit historyMeds/Problems/ResultsPersonal records

Education:Info prescriptionsPatient selected linksPredefined collectionsVideos

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SecuritySecurity

Secure CommunicationEncrypted connections

Secure Messaging

Audited (Audit trail available to patient)

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Compose a Clinical MessageCompose a Clinical Message

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Provider ScreenProvider Screen

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Service RequestsService Requests

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Patient Access to RecordPatient Access to Record

• What should they see?

• When should they see it?• Who else should have access?• How should we present it?

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Personal Health RecordPersonal Health Record

• Patient-entered and maintained

• Data types:– Text– Numeric data– Documents and other objects

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Educational PartnersEducational Partners

• PreOp – Patient Education

• PostCare – Recovery Series

• UpToDate – Provider Edition

• UpToDate – Patient Edition

• Medical Dictionary

• Multum – medication information database

• Lab Test Online

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–19,200 Patients

–168 Attendings (+ 17 NP’s)

–320 Office Staff

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Messaging VolumeMessaging Volume

• Clinical messages: 27.8*

• Prescription renewals: 3.1*

• Referrals: 2.1*

• Appointment requests: 2.6**monthly volume per 100 patients

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PatientsPatients

• Wide diversity

• 57% female• Median age ~43

– 4% over 70 years old

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Patient DriversPatient Drivers

• Secure Messaging with Provider • Access to Medical Records• Convenience

– Request Appointments– Medication Refills– Referrals to Specialists– Review Bills Online

• Education– Disease specific content by experts at CareGroup– Links to medication information– Personalized drug interaction information

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SummarySummary

• Rapid Growth• Enthusiastic Use by Patients• Strong Provider Acceptance• Patients have not abused direct access to providers• Significant evidence confirms value to patients,

providers and institutions