1: Leveling the healthcare playing field with technology and accessibility

It’s nice to see this use of the PHR recognized as a healthcare innovation, especially in a patient population where diabetes is the most prevalent –and the most lethal-- than in any other group in the United States. The concept presented - electronic data sharing - is straightforward, and as a result the potential this tool holds to transform everyday life and improve the health and well-being of this population – particularly the working poor – is nothing short of revolutionary. Diabetes is a time-intensive disease to monitor and manage, not only for the healthcare team but for the patients themselves. For the working poor, quarterly (or at the time of diagnosis, weekly) office visits are not feasible: transportation, inflexible work hours, inability to take a cut in pay may all contribute to what a provider may perceive as lack of adherence. The PHR tool allows patients to share their glucose readings and their efforts electronically to the care team which is a powerful communication tool. While secure messaging with a provider may not reduce the number of appointments needed, the ability to share data and ask questions means that unnecessary visits can be reduced. Oftentimes, the week before a visit, some providers ask patients to perform self-monitoring of blood glucose up to six times a day – no small task for anyone working full time and/or with family responsibilities. The availability of data over weeks may reduce this need for patients with acceptable glucose control. The improved A1C in the participants is a hopeful statistic showing that patient use of the PHR is effective in helping patients organize their self-monitoring activities, allowing patients to take a more active role in its management. Finally, the most powerful aspect of this tool is that it allows participants to have continuous access to their own health data – a concept widely touted by national policymakers yet one that is proving difficult to implement. I look forward to reading about the next phase of the work around this innovation, including the cell phone option for the PHR and how it improves usability. This is a powerful multi-level innovation that transforms chronic conditions management from the point of client contact through the care team. It’s universal accessibility (and affordability) breaks down walls and make health more achievable than it has been before. Congrats and I can’t wait to see what comes next.

J. Osborn, RN, Thursday, December 13, 2012 11:31 pm| University; 0

2:

Thank you for the comments. I am looking forward to the next phase of chronic disease management using the integration of smart phones with PHR and educational portals to enhance patient engagement in chronic disease management. The portablity of patient electronic data is powerful in an underserved minority population where insurance plans change every 6 months.

Gail Nunlee-Bland, Friday, December 14, 2012 8:16 pm| Hospital; Physician

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