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HIT Standards Committee
Consumer/Patient Engagement
       Power Team
    Leslie Kelly Hall, Chair
      Health IT Standards Committee Meeting
                   April 18, 2012
Charge
• CHARGE: Assess the Standards and
  Certification Criteria NPRM and provide
  recommendations for strengthening
  consumer/patient engagement components.
  The Power Team will prioritize
  recommendations to enable patients to
  participate as partners in their care.
Goal
• GOAL: Ensure that MU Stage 2 standards meet
  current opportunities for engaging patients
  and their families in their care, and anticipate
  future policy and technology that encourages
  further engagement.
Consumer/Patient Engagement Power Team
Members
•   CHAIR Leslie Kelly Hall, Healthwise
•   Jon Bertman, Amazing Charts
•   Hugo Campos, patient advocate
•   John Derr, Golden Living LLC
•   Jim Hansen, Dossia
•   Liz Johnson, Tenet Healthcare
•   Nikolai Kirienko, patient advocate
•   Russell Leftwich, Tennessee Office of eHealth Initiatives
•   Alice Leiter, National Partnership
•   Arien Malec, RelayHealth
•   Holly Miller, MedAllies
•   Sean Nolan, MicroSoft Health Vault
•   Heidi Sitkov, nurse, patient advocate
•   Sharon Terry, Genetic Alliance
•   Judy Warren, University of Kansas School of Nursing
Comment Topics
•   Overarching principles
•   Themes
•   Comments for Stage 2 (in combined grid)
•   Frontier issues: borderline Stage 2/3
•   Directional signposts
•   Appendices:
     – Complete comments, with general guidance and recommendations
        for Stage 3
     – table of overarching themes
     – text summarizing key catalysts for patient engagement and health
        care transformation authored by Jim Hansen based on PE PT
        discussions and other subsequent input from multiple sources
Standards and Policy

Policy   Standards     Action
Exists   Don’t         Patient/EHR developed
Gaps     Exist         Harmonization
Exists   Exist         Patient/EHR harmonization
Overarching Principles


• Nothing about me without me
• I am a contributing care team member
• Many EHR actions have a patient-facing
  system reaction
• Patient-facing systems are not limited by
  legacy systems
• How does my care compare?
Specific Themes
    (Examples)
• Understandable to me: plain language, my language
• CC:Me or my designee(s)
• I am a health information exchange of one
• I am a necessary and important safety checkpoint
• I am a credible source of information and generate
  meaningful and material data for my care:
• Clinical information reconciliation needs to include
  patient as participant
• VDT in a computable, transferable, moveable way
Stage 2 Comments


• Comments reflect logical outgrowth:
  – Review identified opportunities
Frontier Issues:
Borderline Stage 2/3

• Patient access should be flexible and
  bidirectional- TO THE PATIENT
  – CC:ME or designee(s)
     CPOE
     eRX
  – Designated proxy
  – Computable & human readable
  – On demand
  – Available as populated
Frontier Issues:
Borderline Stage 2/3

• Patient access should be flexible and
  bidirectional- FROM THE PATIENT
     Current medication list
     Family history
     Smoking status
     Medication adherence and experience
     Experience of care surveys
     Questionnaires
     Patient intolerance
     Patient responses
     Patient initiated data
Frontier Issues:
Borderline Stage 2/3

• Clinical Decision Support
   – Include patient in shared decision making
      • Preference sensitive care
• Patient communication
   – Should include relevant education
• Metadata/ raw data any patient data
   – Computable
   – Discreet
• Care Team Roster - Patient Included
   – Institutional
   – Community
Overarching Principles: Guideposts

• Nothing about me without me: CC:ME
• I am a contributing care team member:
  Patient generates as well as receives data
• Many EHR actions have a patient-facing
  system reaction: Patient orders
• Patient-facing systems are not limited by
  legacy systems: API
• How does my care compare? Patient report
  cards
Take-Aways

• The energy and enthusiasm strong
• The ability of a brand new group, including
  patients, to coalesce and to contribute
• Policy helps innovate standards, but standards
  help innovate policy
• Value of extending this type of effort across
  HITPC and HITSC, jointly or in collaboration

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Patient Engagement Power Team Comments – Leslie Kelly Hall, Chair

  • 1. HIT Standards Committee Consumer/Patient Engagement Power Team Leslie Kelly Hall, Chair Health IT Standards Committee Meeting April 18, 2012
  • 2. Charge • CHARGE: Assess the Standards and Certification Criteria NPRM and provide recommendations for strengthening consumer/patient engagement components. The Power Team will prioritize recommendations to enable patients to participate as partners in their care.
  • 3. Goal • GOAL: Ensure that MU Stage 2 standards meet current opportunities for engaging patients and their families in their care, and anticipate future policy and technology that encourages further engagement.
  • 4. Consumer/Patient Engagement Power Team Members • CHAIR Leslie Kelly Hall, Healthwise • Jon Bertman, Amazing Charts • Hugo Campos, patient advocate • John Derr, Golden Living LLC • Jim Hansen, Dossia • Liz Johnson, Tenet Healthcare • Nikolai Kirienko, patient advocate • Russell Leftwich, Tennessee Office of eHealth Initiatives • Alice Leiter, National Partnership • Arien Malec, RelayHealth • Holly Miller, MedAllies • Sean Nolan, MicroSoft Health Vault • Heidi Sitkov, nurse, patient advocate • Sharon Terry, Genetic Alliance • Judy Warren, University of Kansas School of Nursing
  • 5. Comment Topics • Overarching principles • Themes • Comments for Stage 2 (in combined grid) • Frontier issues: borderline Stage 2/3 • Directional signposts • Appendices: – Complete comments, with general guidance and recommendations for Stage 3 – table of overarching themes – text summarizing key catalysts for patient engagement and health care transformation authored by Jim Hansen based on PE PT discussions and other subsequent input from multiple sources
  • 6. Standards and Policy Policy Standards Action Exists Don’t Patient/EHR developed Gaps Exist Harmonization Exists Exist Patient/EHR harmonization
  • 7. Overarching Principles • Nothing about me without me • I am a contributing care team member • Many EHR actions have a patient-facing system reaction • Patient-facing systems are not limited by legacy systems • How does my care compare?
  • 8. Specific Themes (Examples) • Understandable to me: plain language, my language • CC:Me or my designee(s) • I am a health information exchange of one • I am a necessary and important safety checkpoint • I am a credible source of information and generate meaningful and material data for my care: • Clinical information reconciliation needs to include patient as participant • VDT in a computable, transferable, moveable way
  • 9. Stage 2 Comments • Comments reflect logical outgrowth: – Review identified opportunities
  • 10. Frontier Issues: Borderline Stage 2/3 • Patient access should be flexible and bidirectional- TO THE PATIENT – CC:ME or designee(s) CPOE eRX – Designated proxy – Computable & human readable – On demand – Available as populated
  • 11. Frontier Issues: Borderline Stage 2/3 • Patient access should be flexible and bidirectional- FROM THE PATIENT Current medication list Family history Smoking status Medication adherence and experience Experience of care surveys Questionnaires Patient intolerance Patient responses Patient initiated data
  • 12. Frontier Issues: Borderline Stage 2/3 • Clinical Decision Support – Include patient in shared decision making • Preference sensitive care • Patient communication – Should include relevant education • Metadata/ raw data any patient data – Computable – Discreet • Care Team Roster - Patient Included – Institutional – Community
  • 13. Overarching Principles: Guideposts • Nothing about me without me: CC:ME • I am a contributing care team member: Patient generates as well as receives data • Many EHR actions have a patient-facing system reaction: Patient orders • Patient-facing systems are not limited by legacy systems: API • How does my care compare? Patient report cards
  • 14. Take-Aways • The energy and enthusiasm strong • The ability of a brand new group, including patients, to coalesce and to contribute • Policy helps innovate standards, but standards help innovate policy • Value of extending this type of effort across HITPC and HITSC, jointly or in collaboration