Birds of a Feather PHR

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Birds of a FeatherPHR

HL7 - PhoenixTuesday, Q5

EHR/PHR WGJohn Ritter, Elaine Ayres, Tim Mckay


Agenda Introduction and Welcome High-level display of the new PHR-S FM

functions for nutrition and physical activity The PHR and Mobile Health Nutrition, PHR, EHR, and Mobile Devices

-- The Future is Now! Q&A, Status, Issues, and Next Steps

01/01/20112


Description of the Nutrition and Diet Information Section

Nutrition is related to health and wellness as well as chronic diseases. People want to record and monitor their food and nutrient intake including any nutritional supplements because they are trying to manage their weight, maintain their fitness level, or demonstrate progress towards the goals in their nutrition care plan.

01/01/20113


Examples of Nutrition & Diet Information

Food and nutrient intake records Liquid nutrition supplements (nutraceuticals) Enteral and parenteral feedings Vitamin, mineral and herbal supplements History of breastfeeding Diet recommendations provided by a Registered Dietitian Tracking information such as weight, height, and Body

Mass Index (BMI) Food allergies and intolerances Physical activity records

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Criteria 1 1a. The system SHALL provide the ability for the

PHR Account Holder to manage information regarding the PHR Account Holder's nutrition and/or diet.

1b. The system SHALL provide the ability for the PHR Account Holder to manage concerns (either self-generated concerns or concerns that were expressed by others) that relate to the PHR Account Holder's nutrition and/or diet.

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Criteria 2 2a. The system SHOULD provide the ability for the PHR Account

Holder to capture his or her nutrition and diet information (specifically, current intake of foods and/or nutrients).

2b. The system SHOULD provide the ability for the PHR Account Holder to capture his or her nutrition and diet information (specifically, past history of intake of foods and/or nutrients (e.g., anorexic during teenage years; vegetarian from age 5 to 10).

2c. The system SHALL provide the ability for the PHR Account Holder to import diet and nutrition -related data from a provider's EHR system or from other sources (e.g., diet-related instructions from a provider; diet-related orders; or diet-related information that appears on an assessment).

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Criteria 3 3. PHR system SHOULD allow for entry and

tracking of nutritional supplements, multivitamin and herbal products as discrete data or lists.

Question – should this be merged with other medication functionality?

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Other Criteria Analyze drug-herb interactions and render a

notification or alert Analyze and render nutritional information by

calculating nutrient values for items or total daily intake summaries

Exchange food intake information and/or nutritional analysis data with third-party applications

Capture, maintain, and render physical activity information including total workout data

Capture, maintain, and render educational information

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Use Case 1 The PHR-S maintains a food and nutrition

history list that may be followed by the PHR Account Holder and referenced by his or her providers and Registered Dietitians.

Copies of the PHR food and nutrition history list may be kept by their providers in their EHRs.

01/01/20119


Use Case 2 The PHR-S maintains a list of nutrition and

diet-related information including food intake records, nutrient analysis summary records, energy balance data and nutrition care recommendations.

This list may be followed by the PHR Account Holder and referenced by his or her providers including a Registered Dietitian

01/01/201110


The PHR and Mobile Health The PHR/Mobile Gap Analysis Sub-group was established

to determine the extent of changes needed in the PHR-S Functional Model to accommodate the use of mobile devices within the model.

Scope: Review recently balloted PHR-S functional model to

determine how the introduction of mobile devices as actors within the model may result in changes to the model.

Make specific recommendations to the PHR-S functional model in terms of additional conformance criteria and/or creation of a mobile-specific profile for the PHR-S.

01/01/201111


PHR/Mobile: Completed Work The team has generated a bulleted list of

issues to use in determining the need for changes to the PHR-S.

Items fall into three overlapping categories Device characteristics (location services, camera,

accelerometer, screen size) Device context (location of use, BYOD, destination vs.

conduit) User actions (shared devices, device misplacement)


PHR/Mobile: Next Steps Review the PHR-S Chapter 3 conformance

criteria to determine need for new/updated criteria.

Consider the need for a mobile-specific PHR-S profile in light of the Chapter 3 review.


The PHR and Mobile Applications

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Mobile optimized page vs. mobile application

85% of US adults own a cell phone – of those 53% own smart phones


What if……… Your smart phone is your PHR?

Utilize various applications Collect data (or information) from various

apps and transfer to the mobile PHR PHR then provides reminders,

suggestions or calculations PHR enables transfer to other systems

01/01/201115


How Many Apps? According to MobileWalla (this morning)

13,110 Health Apps 475 Diet and Nutrition Apps 3534 Exercise and Physical Activity Apps 574 PHR Apps!!

My Fitness Pal has over 30 million users 19% of all smart phone users have a health app

and of those exercise, diet and weight apps are the most popular (Pew Internet) 11/12

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Mobile Phones Phones – texting reminders like Text4Baby

Low and Middle Income Countries (LMIC) Often mobile phone only source of information Use for notifications Use for reminders

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Smart Phones Weight Management Use Case

Establish a goal for weight and body mass index in the weight management app

Record weight data on a weekly basis NOTE: may use a smart scale to provide weight

data directly to app Record daily food intake in a “diet” app

Monitor daily caloric intake Collect data in PHR (or PHR app) PHR provides educational information on weight loss

tips and behavior modification

01/01/201118


Smart Phones Shopping Use Case

A Diabetes management app develops a shopping list with suggested foods

An embedded bar-code reader captures all of the foods purchased

A list of foods purchased is recorded and sent to the PHR

The Registered Dietitian reviews the list of food purchased as a way to monitor compliance

01/01/201119


Smart Phones Vitamin/Mineral/Herbal Supplement Use

Case A supplement tracking app records use of

vitamins, mineral and herbal supplement use The list of compounds used is added to the PHR The PHR sends the list to the EHR Prior to upcoming surgery, patient notified to

discontinue herbal supplement use based on adverse impact on anesthesia

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Smart Phones Physical Activity Use Case

Physical activity app measures daily exercise routines

Point of care testing for blood glucose tracks daily blood sugar levels

Data is transferred to PHR PHR correlates and graphs relationship of

exercise in managing blood glucose levels

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Smart Phones Allergy and Intolerance Use Case

Junior eats some nuts at home and develops a rash around his mouth

Mom takes a picture with her phone and sends to her PHR app

Mom heads to the emergency room where an allergy to nuts is added to Junior’s allergy list

The allergy list is then updated in the PHR and includes the associated reaction photo

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In Closing….

Q and AStatus of projectNext steps

01/01/201123

Birds of a Feather PHR

Documents

Transcript of Birds of a Feather PHR