Preparing for Integrating Patient-Generated Data into an EHR


By William van Doornik, RHIA, MS, Executive Consultant, Advisory Services, Beacon Partners
Twitter: @BeaconPartners

Patient portals, mobile apps, secure text messaging, and email are increasing collaboration between providers and patients in new ways. Meaningful Use Stage 3 proposed requirements will likely be a driving force in determining how patient generated data (PGD) will be interpreted, used, and integrated into electronic health records (EHRs). Considering that 70 to 90 percent of diagnoses can be determined by a health history alone, innovations that encourage use of PGD will continue to emerge as organizations focus on achieving high quality care outcomes to obtain reimbursement.

In addition, more than 60 percent of patients want to communicate with their providers electronically now, according to an Office of the National Coordinator for Health Information Technology report. Although mobile devices, wearable technology, telemedicine, and mobile applications offer promise for increasing patient engagement and providing a more comprehensive picture of a patient’s health outside of a provider visit, organizations need to establish workflows, stakeholder accountability, patient education programs, and expectations to use the data effectively, securely, and safely.

Where Do You Start?

Using a team approach, below are six essential steps to establish an organization’s readiness to incorporate PGD into the EHR:

  1. Conduct an IT inventory and workflow assessment. Understanding the organization’s IT system bandwidth and determining which apps can be integrated into the EHR is the first step. Managing data storage, provider notification of PGD data entries or requests, IT workflows, as well as establishing interoperability with current systems and apps needs to be in place to efficiently, effectively, and securely use resources to manage data.
  2. Evaluate patient Internet access, mobile app usability, and health literacy to customize education programs. An assessment of Internet access, mobile app usability, health literacy, among other factors that may influence generation of PGD, can determine gaps, areas of remediation, and opportunities. In addition to posting an evaluation tool on the patient portal, patients can be assessed using a survey during the registration process. After survey data is analyzed, education programs can be tailored for different populations (e.g., adolescents, seniors, etc.) to enable patients to record, organize, store, and share data that can influence change.
  3. Create an information governance structure to manage PGD. Identifying what data is needed and how it will be aggregated, stored, interpreted, used, and shared in the EHR involves a multi-disciplinary approach. While the information governance infrastructure can drive the vision of how PGD should and will be used, creating a business intelligence (BI) competency center — which is a cross-functional team that supports and promotes the effective use of BI across an organization — can tactically collect, aggregate, archive, and share data for use. The expertise of clinical, health information management (HIM), informatics, risk management, and library professionals can be valuable in managing PGD.
  4. Adjust workflows and roles to manage information flows. As patients continue to collect and record an increasing amount of information, managing data will involve delegation, as well as require new roles and responsibilities. Technicians, medical assistants, or medical scribes may be well-suited to take on an information management role – such as collecting and summarizing PGD for clinicians – during the intake process so providers can maintain efficient office practices.
  5. Set expectations about use of solicited and unsolicited PGD. Managing information overload is a common challenge for many healthcare providers. Clinicians need to determine what types of data will be useful in informing diagnosis and treatment decisions. Setting limits with other practice providers, organizational leadership, and patients about clinical information use is also needed to consistently and effectively measure, collect, record, and share specific types of data. Expectations should be set with patients regarding the reasonable receipt and review of unsolicited information.
  6. Create resource lists of “certified” apps to prescribe to patients. Providers and healthcare organizations that want to recommend apps to their patients should create a standard list of those that they find useful and that can support their patients.  While this is best managed with an internal team, external sources, such as the HIMSS recommended evaluation sources Happtique (which was recently acquired by SocialWellth) and, can help clinicians select apps that might be useful to patients.

Combining PGD and telehealth innovations can increase patient engagement, accelerate time to arrive at a diagnosis by providing a comprehensive view of patients’ daily activity, and improve treatment compliance. Yet a significant multi-disciplinary undertaking is involved in developing infrastructure, expectations, and education to support how information is collected, shared, analyzed, and used.

This article was originally published on Beacon Partners Blog and is republished here with permission.