Page 83 - Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

HeALtH LiteRACY, eHeALtH, AnD CoMMUniCAtion

it serves because those members have so many providers. A member may
go to a public health clinic, an emergency room, and two or three clinics
in a just a few months. If the patient’s health information is dispersed
throughout all those sites, it can contribute to poor outcomes for the
member. MiVIA, as a single storage site, can facilitate better coordination
and outcomes. This does not mean that the various facilities do not have
their own charts, but all the information relevant to the member is stored
in the MiVIA personal health record.
The same participant asked what the repercussions are regarding
reimbursement and revenue streams for using these electronic tools, espe-
cially for the providers who are providing clinical care.
Solomon replied that, for MiVIA, the members are mostly uninsured
and use clinics that are reimbursed under special programs. It is critical,
however, to start looking at how to promote reimbursement to providers
so that they participate as partners with their patients in getting this infor-
mation online. PHRs, especially with vulnerable populations, contribute
to costs savings because results of tests are located in the record, which
negates the need for running the same test or for scanning multiple times
as the patient visits multiple providers.
One participant said that hearing about the Shared Care Plan is awe
inspiring. How applicable is it to other parts of the country? The Shared
Care Plan is in a rural area with a defined set of providers, and the patient
research was conducted in that community. What can be learned from that
work to think about how to apply this in other places?
Gauthier responded that the circumstances in Whatcom County did
enable the project to move farther than, perhaps, other locales would.
What was done in Whatcom County is available for download, but what
is of foremost importance is that those constructing PHRs should conduct
user research. One may or may not end up with the same kind of PHR
that Whatcom County did. Certainly the example of MiVIA shows that
things vary from city to city.
Another very important lesson is to give patients the respect they
deserve for what they are trying to accomplish in the health care system.
Many people have the attitude that getting clinicians together in a room
to brainstorm about what patients need is sufficient, but that is simply not
true. Just because a clinician works with patients on a day-to-day basis
does not mean that the clinician understands what patients are experienc-
ing at the pharmacy or when they go home.
Another useful thing would be to standardize the definition of a per-
sonal health record and the components that make up that record. Solomon
said that the Markle Foundation, as part of its Connecting for Health
work (http://www.connectingforhealth.org/workinggroups/personal
healthwg.html), will be releasing some recommendations, principles, and

Copyright National Academy of Sciences. All rights reserved.