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Symposium Abstracts
Below you will find a listing of abstracts that will be presented at this year's symposium. Listings are organized alphabetically by author. Click on an author's name to browse through the abstracts.
Underneath each abstract you will find a link to download each presenter's Symposium Presenation in PDF format.
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Toward interoperable personal health records
Mary Jo Deering, Ph.D
Director for Informatics Dissemination
NCI Center for Bioinformatics
National Cancer Institute
National Institutes of Health, USDHHS
Abstract
Personal health records have the potential to greatly improve the quality of health and health care for individuals by enabling them to collect, manage, and share (as they desire) all their relevant personal information--including daily health status, care, medications, lifestyle factors, and much more. However, the term "personal health record" covers a wide variety of programs offering diverse content and functionality. Many do not actually contain any personal health data; some are just "views" into healthcare providers' electronic health records (EHRs); and none currently exchange personal data with EHRs. The ultimate value of PHRs will not be achieved until they are interoperable with EHRs and other sources of personal health information so that they are comprehensive and reliable. Many challenges lie in the way of this vision: identifying the populations who can benefit most from interoperable PHRs and which PHR technologies are most valuable for them; working through privacy and security issues, particularly around personal control of the PHR and secondary uses of PHR data; and ensuring that PHRs can fit into the workflow of healthcare providers – i.e. integration with care in addition to technical interoperability.
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The Link Between Electronic Disability Records and Occupational History
Stephen Demeter
Author, Disability Evaluations
Abstract
Occupational history is an important piece of the medical record. This presentation will discuss the application of electronic medical records to occupational medical practice and will highlight the importance of occupational history by presenting use cases. Lack of proper occupational history collection may cause mismanagement of certain cases. Basic guidelines on how to collect a complete history will be provided. Some media tools and resources that are of some value in the occupational practice will be addressed. Occupational history is an important part of disability evaluations as well. The presentation will provide the linkage between electronic disability records and EMR. The potential of PHR systems in enabling a more accurate history collection process that can facilitate the creation of a comprehensive health record will also be discussed.
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An Archaeology of the Commercial PHR Movement
Matthew Holt
Abstract
It can be argued that we are in the third wave of an attempt by technology entrepreneurs to sell Americans personal health records (PHR). So far this movement has met with little success, despite the very fast growth of the Internet as a source of health information by consumers, and a simultaneous explosion in the use of online (and offline) tools and software for managing other personal information, such as financial information and music collections. This presentation attempts to create an archaeology of the commercial PHR, a surveillance of the current landscape at ground level, and an effort to interpret what current research is telling us about likely future directions for PHR use. It will also deliver a surface level topology of different types of PHR.
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Up Close and Personal: Standards and Person-Centric Electronic Health Records
Robert A. Jenders, MD, MS, FACP
Associate Professor of Clinical Medicine
University of California, Los Angeles
Attending Physician, Department of Medicine
Informatician, Enterprise Information Services
Cedars-Sinai Medical Center
Abstract
Realizing the promise of electronic health records, including person-centric systems, necessitates interoperability. Interoperability, in turn, requires standards for data representation, electronic communication, knowledge representation, system function and decision support. Especially pertinent to electronic communication is the connectivity between personal health records and the wider enterprise that institutions such as a regional health information organization can provide. Delivered from the perspective of a leader in a standards development organization, a clinical educator and a clinician, this presentation will delineate the need for standards in these areas; describe existing standards and efforts underway to augment them; and review the importance of harmonization of standards.
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A Hybrid Model for the Disability Benefit Industry
Steeve Kay
President, QTC Management Inc.
Abstract
Each year, America pays $400 billion for disability-based benefits. Yet, the disability benefit industry is a component of healthcare that is grossly misunderstood because of its hybrid and complex characteristics: The hybridization results from gathering medical evidence as Inputs from one or both of two sources – collecting a claimant’s prior medical treatment records and/or ordering a specialized disability evaluation report. The medical evidence is then organized into a disability claim file ready to be Processed by the disability claim professional for rating or adjudication decision. The Output of this decision-making process – namely the disability benefit – can take one or both of two forms: cash compensation and/or rehabilitation medical services at no cost to the claimant.
The claim decision is not based on medical treatment know-how, but from a set of regulatory rating or adjudicating criteria formulated by the disability benefit payers such as government agencies or property and casualty insurance carriers. To further the complexity, the custodian of medical documents is also different: Medical providers are the legal custodians of medical records in the case of medical treatment discipline, whereas disability benefit payers are the legal custodians of medical evidence associated with the claim. As such, the Interoperability between Electronic Medical Records (EMR) generated in the medical treatment community and Electronic Medical Evidence (EME) collected and organized by the disability benefit payers poses some unique challenges. This paper seeks to clarify these hybrid issues and provides a high-level view of the Interoperability challenges.
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Myhealth eVet (MHV): The Model Personal Health Record of the Future?
Leonard Kleinman, MD, MPH
Associate Clinical Professor of Medicine, Geffen Medical School at UCLA,
Telehealth Director, VA Greater Los Angeles
Abstract
MyHealtheVet (MHV), VA’s PHR, has been undergoing phased implementation by the Veterans Health Administration Office of Information since Veterans Day 2003. It represents a large scale effort to implement a model PHR to complement VA’s successful VISTA EHR. Some success has already been achieved: As of October 2005, there were over 113,000 registrants nationwide who make over 9000 site visits to daily. Beyond the health education library feature commonly available on other websites, MHV now has many interactive features less commonly available including patient entry of health information and self-obtained metrics in a personal health data repository (eVault) and performance of personal transactions, such as VA pharmacy prescription refills. More interactive features are scheduled to be added in Spring 2006 including release of reports from the patient’s VISTA record, viewing of appointments, viewing of financial account balances, and provision of delegation capabilities. Other interactive features, such as secure clinician-veteran messaging, are currently being piloted. In parallel with MHV, Southern California and Southern Nevada VA facilities in VA VISN 22 have developed their own independent PHR, Web Portal, that overlaps with MHV and offers additional features. This development has had advantages and disadvantages for stakeholders.
Overall, MHV and Web Portal have been well-received and have further empowered veterans to manage their own care. However, there have been important lessons learned and unresolved issues that merit further study. These include effective communication of plans to stakeholders, implementation of security protocols, coordination of national and local efforts, methodology for stakeholder feedback and formative evaluation, and management of the ever rising expectations of stakeholders.
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Seamless Health Record
Jose C. Lacal
Sr. Manager
Seamless Health Research
Motorola
Abstract
The Seamless Health Record concept includes a family-centered, portable, personal, prevention-oriented Health Record Platform of services to maintain, enhance, and restore an individual's health. This concept leverages the growing power and sophistication of mobile computing and communication devices, and the expanding capabilities of wireless communication networks.
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Predicting Patients' Satisfaction with Provider eHealth
E. Vance Wilson, Nancy K. Lankton
E. Vance Wilson
School of Business and Administration
University of Wisconsin-Milwaukee
Nancy K. Lankton
Eli Broad College of Business
Michigan State University
Abstract
E-health websites incorporating informational content and advanced functions such as appointment scheduling, refilling prescriptions, and communicating with clinicians are now offered by many healthcare providers. Potentially, provider e-health can improve patient services and contain costs, assuming patients are satisfied with it. However, little research investigates the determinants of satisfaction specific to e-health. We tested a direct effects model of expectations and performance to predict patients’ satisfaction with provider e-health. We surveyed new registrants to provider e-health to assess antecedent characteristics and initial expectations of e-health services. We followed three months later with a survey assessing performance perceptions and satisfaction. Our overall model explains over two-thirds of the variance found in satisfaction, and direct prediction of satisfaction by antecedent characteristics explains 41% of variance in satisfaction. The findings suggest several ways provider organizations can improve patient acceptance of e-health based upon patient characteristics and provide interesting directions for future research.
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Investigate Insurance Claims Data as a Data Source for an Electronic Patient Record
Cynthia LeRouge, PhD., Gordon Wong, M.D., Ph.D.
Cynthia LeRouge, Ph.D.
Decision Sciences/ MIS Department
St. Louis University
Gordon Wong, M.D., Ph.D.
Saint Louis University Center for Outcomes Research
St. Louis University Medical School
Abstract
Policymakers and physician leaders are counting on electronic health records to improve quality of health care and revitalize practice . Rapid, consistent integration of diverse information sources is a key issue in fulfilling these promises in a disbursed medical distribution system. The challenge to a complete history is one of providing a needed depth of information associated with each encounter and breath of information that includes all medical encounters (across providers and time). The possibilities of an electronic patient record that reflects both depth and breath of service may be well served by synergizing medical chart data and extracting useful information from managed care/health insurance administrative data. Health insurance claims data is consistently updated to provide a connecting link that tracks patients from one provider to another according to dates of service. The current study explores the use of clinical claims data as an electronic patient record source of data spanning providers and time.
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E-Healthcare and the Promise of a Consumer-Centric Health System
Synthia Molina, BS, MBA
Synthia is an expert in industry development, market leadership, and quality systems. She has more than two decades of experience in the health and management education industries, and she currently focuses on value creation at the convergence of the healthcare, information technology, and business-to-business sectors.
This session will first examine the targeted functionality and benefits of a National Health Information Network (NHIN) and then focus on the critical role of health-related data standards (HRDS), health information technology (HIT), and electronic health records (EHRs) in ensuring more Americans get cost-effective care in an optimal setting at a rational price.
Working backwards from the desired end states of consumer centricity and just-in-time availability of intellectual, material, and monetary resources to support cost-effective care, participants will gain an understanding of how disparate efforts at health information infrastructure development must converge to advance individual and public health, business and industry efficiencies, and socioeconomic development.
A review of NHIN-related initiatives associated with health-related data standardization, collection, management, analysis, and reporting will make clear what remains to be done in standard-setting, inter-organizational communications, and health record implementation to achieve a consumer-centric and interoperable NHIN.
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Personal Health Records: National Trends and Challenges
Helga Rippen, MD, PhD, MPH
Senior Advisor, Health Informatics,
Office of the Assistant Secretary of Planning and Evaluation,
DHHS
Abstract
Electronic personal health record (PHR) is moving toward becoming an important part of the healthcare system. This presentation will address national directions and challenges related to PHR. The presentation commences with a quick review of national and federal issues in the healthcare field. The focus of the presentation will then turn to the concept of consumer control and the policy implications therein. In addition, the presentation will address research challenges such as the difficulty of representing consumers’ thinking without the influence of the government, concerns about privacy and security of health information, and barriers and opportunities in linking health related data to broader public health analysis.
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Implications of Electronic Medical Records for Disability Policy, Present and Future
David Stapleton, PhD
Cornell University
Abstract
Numerous disability programs for working-age people with disabilities would greatly benefit from the widespread availability of electronic medical records and eligibility determinations that take full advantage of recent developments in information technology. Eligibility determinations use an enormous share of the resources devoted to administering the major disability programs, and improvements supported by advanced electronic systems would both free resources for service delivery and provide information to improve service delivery. Even more intriguing is the potential of advanced electronic systems to support program reforms that would replace caretaker policies of the past with policies that, in line with the goals of the Americans with Disabilities Act, allow people with disabilities to take full advantage of their abilities, increase their self sufficiency, and participate more fully in all aspects of our society. Such reforms might even reduce the unsustainable growth rate of public spending to support this population.
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Electronic Medical Records as an Enabling Technology
Jeffrey Bishop and Dr. Bruce White
Quinnipiac University
Abstract
The healthcare industry has been somewhat slow and reluctant to adopt new information technology. The reluctance of physicians to adopt information technology and information systems is an interesting scenario, which merits further analysis. As there are multiple information technologies available to physicians, this chapter focuses on one of these technologies; electronic health records. It is the contention of the authors that if physicians could overcome the barriers to entry, which currently prevent them from making the transition to electronic health records, they could gain a significant competitive advantage over their peers, who use paper based records.
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The Technological Transformation of Self-Care: A patient driven adaptation of the technology acceptance model for evaluation of patient-accessible electronic medical records
Warren J. Winkelman, MD, FRCPC, MBA, PhD
The Centre for Global e-Health Innovation
Toronto General Hospital
Abstract
This presentation explores what patients living with chronic illness know or think they know about patient-accessible electronic medical records (PA-EMR) to ultimately understand how healthcare organizations can best approach formative evaluation of this technology in the social context of the patient-user.
Patients are EMR users with motivations and work requirements that are distinct from organizational employees and professionals. Their approach to information is highly social and invested with emotion, perceiving usefulness of an EMR system in terms of its promotion of illness ownership, patient-driven communication, personalization of content, and trust.
Therefore, patient-user based formative evaluation of PA-EMR also requires critical consideration, appreciation and understanding of the patient’s emotional-affective relationship with health information and information technology. Implications for systems designers, health policymakers, physicians, patients, and healthcare organizations are to be discussed.
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2012 Claremont Graduate University 
School of Information Systems and Technology 