Personal Medical Record Initiative for Consumer-Physician Decision Support

Project Team

The project team will consist of the following individuals:

1. Project coordinator
2. Medical Director of CFH
3. Director of the Division of Medical Informatics
4. Medical Statistician
5. Data mining/pattern recognition informaticist
6. Knowledge management specialist
7. Informatics A-CPR technologist
8. Smart Home CTO
9. Chair of the physician panels

Goal of Personal Medical Record Initiative

An overarching goal of the Center for Future Health is to provide consumers timely data for personal health management. Currently data are collected during physician visits and through test results. However, this is usually when a symptom presents itself, often too late for early detection and prevention. Among the questions being asked are:

• What happens to a person's physiology and mindset between visits to physicians?
• How do we capture and use these data in a timely way while maintaining privacy?
• How do we make it easy for consumers to make informed health behavior choices?
• How do we make it easy for consumers and physicians to discuss treatment tradeoffs?

The Personal Medical Record Initiative for Consumer-Physician Decision Support project identifies three interlinking aspects of attention:

1. PHS Informatics - Data from the Personal Health System that are collected, analyzed and transformed into information which is communicated to users by Physicians from the Personal Health System, the clinics, other providers, and the ambulatory computerized patient record
2. A-CPR (Ambulatory Computer Patient Record) Interface - Data which are collected, analyzed and transformed into information which is communicated to users by Physicians from the Personal Health System, the clinics, other providers, and the ambulatory computerized patient record.
3. DSI (Decision Support Interface) - A context based dynamic graphical approach to presenting information and tradeoffs for shared decision-making

Goals for Each Aspect of the Personal Medical Record

1. PHS Informatics - Establish an informatics research program addressing General Health, Cancer, and Cardio-vascular disease. Start by using data from measuring existing vital signs. Then, move to supporting the addition of data from the new vital signs.
2. A-CPR Interface - Integrate Personal health status information from patient medical records in physician's offices, hospitals, and the Personal Health System in their homes. Create and test linkages with URMC's ambulatory computerized patient record (A-CPR). The A-CPR product, about to be implemented in selected practices at URMC, includes the ability for providers to share selected results and longitudinal health data with their patients using a secure, authenticated, patient web based portal.
3. DSI - Demonstrate and validate dynamic graphical medical record decision support system for improved early detection and health management, for use by consumers and their physicians, including but not limited to visual information, textual information, relational information, and tradeoff analysis. Use the graphical capabilities of the computer to portray clinical information in a highly intuitive, explicit manner. See at a glance the user's current clinical status, and intuitively navigate through the medical record. For closer examination, focus on specific sections of the clinical record and clearly see patterns and relationships that emerge. Enable problem solving by exploring different changes to the user's specific medical record.

Benefits of the Personal Medical Record

To the User (Consumer/Patient):

• Easy to use information about their health status and choices
• Easier to explain their concerns and ask questions with reliable data they have collected
• Improved communication with physicians
• Early detection, prevention, and disease management

To the Physician:

• A window into the patient's behaviors between visits
• Easier for physicians to talk with patients about clinical management scenarios
• Easier to describe the relationship between actions, adherence, and outcomes
• Provide an easy to use longitudinal record
• Increased patient involvement and adherence because of improved patient understanding

This approach enables users and physicians to better understand the Personal Health System record, the clinical record, to better communicate with each other, and to make informed health care choices. As a result, there will be improved health management and much earlier detection of physiological changes. This will lead to earlier interventions, and less costly procedures.