Regardless of the U.S. administration’s “meaningful use” requirements, if health information technology (HIT) is to become meaningful for patients, it must include the prescription of information and tools to help each patient better manage his or her own care.
Ask patients what they want from HIT systems, and they will tell you three things:
– “Tell me my diagnosis, what will happen, and what I can do myself to better manage the problem.”
– “Tell me my medical tests results and what they mean to me.”
– “Tell me my treatment options, and help me participate in the treatment decisions.”
The soon-to-be-finalized HL7 International Context-Aware Information Retrieval standard (nicknamed the HL7 “Infobutton” standard) makes it far easier for providers of electronic health records (EHRs) and personal health records (PHRs) to deliver just what the patient wants. And that is what will put the meaning into meaningful.
Using the HL7 Infobutton Standard for Information Prescriptions
The HL7 Infobutton standard has been widely adopted since 2007. It facilitates the delivery of a set of standardized information about the patient, the provider, and the activity of a specific care encounter or moment in care. An Infobutton manager (or equivalent) accessed by an EHR application can then pull from that set the information it needs for any relevant use case. In most cases the Infobutton has been used to bring up decision support information for the clinician.
This same HL7 standard can also be used to trigger relevant, helpful patient education orders or “information prescriptions”—for the patient. While the knowledge request can be triggered by the click of a button, the button click is not always necessary. The information prescriptions can be automatically generated, based on the context of the patient’s particular moment in care, for presentation in a handout or secure message, or on the personal health record (PHR).
In an EHR, a clinician triggers a knowledge request to a content provider. (A knowledge request differs from a query, because it returns tailored, targeted, and relevant information instead of the overabundance of documents with varying degrees of relevance that a standard query might deliver.) The content provider responds with a list of patient information prescriptions appropriate for that patient and that specific care encounter.
In the PHR, the request can be launched by the patient or automatically triggered by a scheduled appointment, a preventive service that is due, a medical test report, or any other clinical event. The content provider responds with relevant Web-based consumer health content.
By having both synchronous and asynchronous triggers, systems can generate relevant, helpful information at every point in the health care continuum. In all cases, the knowledge request and response protocols are defined by the HL7 Infobutton standard. This minimizes development effort and provides a single consumer content integration solution for both HIT developers and content providers.
Download the full white paper: “Getting Patients to Meaningful Use: Using the HL7 Infobutton Standard for Information Prescriptions (PDF)“
As chairman and CEO of Healthwise Mr. Kemper is a passionate advocate for raising the quality of patient engagement in health care. By prescribing prevention, self-management, and decision-support tools relevant to each patient’s needs, clinicians can engage and motivate their patients to become active partners in their health and wellness. Mr. Kemper co-authored Information Therapy: Prescribed Information as a Reimbursable Medical Service with Molly Mettler. More information about Healthwise can be found at http://www.healthwise.org/.
I want to incorporate the info button in my EHR application can you let what all points i should keep in mind.
With the help of IT the field of health care would gloom to the zenith. Changes are constant and good changes are appreciatable.
EMR/PHR vendors are already providing patient education resourcources for a nominal fee. See eClinalWorks and Athena Health as examples. These vendors know that patient engagement will facilitate EMR/PHR adoption by clinicians. Patient education materials must be delivered concurrent with access to patient information. Without it, new costs and confusion will enter the currently overburdened health system. By adopting this standard within the MU rules, we have a unique opportunity to provide meaningful use of information by patients and their families in a cost effective way.
Oh, I definitely will. I also want the Advanced Directives added back in.
My optimism springs from the realization that giving patients access to their lab results without access to the information that explains them will result in a demand for the information and the Info-Button standard connected to “patient-specific educational resources” will be a relatively low-cost fix to the problem. Never mind that it is a morale imparative to inform patients of their options or that such an information service will bond the patient to the provider. In addition I am expecting a groundswell of comments requesting CMS to add the “patient-specific educational resources” back into the final rule for Stage 1 and, if not that, at least Stage 2. I’d invite you to join that effort.
Don, if I’m not mistaken, the requirement for patient specific education handouts and material has been removed from the MU IFR for 2011.
So even though the APIs and the Info are readily available, for a rather hefty price, from some content vendors (see WK), I am not too optimistic about widespread implementation in the very near future.
Maybe if HHS provides a good content resource for free, some vendors would be inclined to put it in the EHR/PHR as a competitive advantage….