Partnering with patients to change a paradigm

This week we celebrate National Health IT Week. I have the honor of working with some of the best health IT professionals in the country. As part of the HIMSS eConnecting with Consumers Committee commitment to equip frontline clinicians and providers with information and resources on HIT the volunteer committee is releasing a new white paper, “The Need for PHIT Changing a Paradigm with Personal Health IT (PHIT) to Transform Healthcare.”

The main points from this new body of work, with a call to action to providers, are highlighted below.

Providers and consumers meaningfully use PHIT
A growing cadre of U.S. patients -- alternatively called “consumers,” “caregivers” or “health citizens” -- are engaging in their own health and healthcare, as well as for the health of the people they care for. This enhanced level of patient engagement is enabled through “personal” health IT (PHIT).

Consumer adoption of PHIT is accelerating due to convergence of social and economic forces:

  1. Growing dependency on digital technologies in everyday life;
  2. Expectation of real-time access to services;
  3. Increasing clinical and financial responsibilities for patients;
  4. Pressure on providers to embrace value-based payment and incentives for patient outcomes; and
  5. Regulatory and legislative mandates.

Mainstream IT morphs into health
Useful tools equip patients with information that increases their knowledge and authority as “health consumers.” Most consumers’ use of PHIT occurs outside of their interactions with physicians and the larger health system. Providers have much to gain by embracing their patients’ proactive engagement with PHIT.

Providers and consumers meaningfully use PHIT
Patient engagement is also an integral part of the HITECH Act for establishing meaningful use (MU) Stage1 and Stage 2 incentives. These incentives are building blocks for providers to constructively engage patients to:

  1. Support behavior change;
  2. Enhance care transitions; and
  3. Improve patients’ health outcomes.

As detailed in Engage! Transforming Healthcare Through Digital Patient Engagement (HIMSS, 2013), PHIT can bolster patient engagement by enabling people to:

  • Better understand their health and health conditions;
  • Obtain access to their own health data in real-time or near-real-time;
  • Improve communications with their doctors and providers;
  • Take more responsibility for their own health and health outcomes;
  • Improve their experience of interacting with the healthcare system;
  • Inform and educate their families and caregivers; and
  • Get support about health and healthy behaviors from family, friends, caregivers, and health professionals.

Engage! identifies six categories of PHIT:

  1. Communications;
  2. Convenient self-service;
  3. Personal health information;
  4. Financial;
  5. Education and support; and
  6. General capabilities.

Health persona and PHIT
Putting more of the “P” (“personal”), into PHIT will require incorporating individuals’ preferences and values into the applications, including personal observations of daily living (ODL).

To help inform the smart design of PHIT, it is useful to consider archetype examples of people who could benefit from such tools.

Patients continue to trust their personal physicians above most other professionals, following nurses and pharmacists. These professionals all play a crucial role in recommending (“prescribing”) PHIT to patients and caregivers.


Prospects for PHIT
Thus, overcoming barriers to patient engagement and mass adoption of PHIT are also addressed:

  • How can a specific PHIT be matched to someone having a health concern?
How will an individual, whether patient, caregiver, consumer, provider, navigator or other person, identify and access the PHIT that is well-suited to their need?
  • Who will pay for PHIT?
Will aligning incentives for value-based payment motivate health providers to “prescribe” PHIT?
Will patients be willing to pay for some portion of the cost if called on to co-pay?
  • Will payers be willing to accept PHIT as a covered intervention?
Will employers’ shift toward value-based benefits and wellness foster PHIT adoption?
  • How does the health-digital divide (and more generally, health disparities in America) play into PHIT adoption and sustaining use?

Some patients who may benefit most from PHIT may be among the least health-engaged.


A provider call to action
PHIT can support patients and providers in achieving better health outcomes, streamlined workflows and cost-effective use of scarce resources: labor and money.

Patients continue to trust their personal physicians above most other professionals, following nurses and pharmacists. These professionals all play a crucial role in recommending (“prescribing”) PHIT to patients and caregivers.

HIMSS members continue to support providers in their quest to partner with patients and their families and to meaningfully use health IT to improve their health status. We ask the provider community to review the paper in its entirety and to embrace and identify how PHIT can be incorporated into practice. More importantly we ask you to share your success story in the new HIMSS Health IT Value Suite.

What would you like to know about provider-patient engagement?
HIMSS will launch a new provider-patient community of practice for HIMSS members in Fall 2013, and we need your help in determining the topics and speakers for the upcoming year. Please take a minute to complete a short survey to indicate your areas of interest and how HIMSS can best help you on your journey to e-engagement.

Together we can all partner to transform healthcare.

Mary P. Griskewicz, MS, FHIMSS, is HIMSS senior director of Ambulatory Health Information Systems.