[Openid-specs-heart] EHR, PHR, FHIR resources.

[Glen Marshall [SRS]]

Aaron,

Thanks for the clarification.  I thought it was systems that were tied 
to one another, not the patient being tethered.

At latest count I have 7 "tethered" patient portal accounts, none of 
which communicate with each other nor with my PHR account.  Quest is a 
happy exception.

Glen


*Glen F. Marshall*
Consultant
Security Risk Solutions, Inc.
698 Fishermans Bend
Mount Pleasant, SC 29464
Tel: (610) 644-2452
Mobile: (610) 613-3084
gfm at securityrs.com
www.SecurityRiskSolutions.com

On 11/17/15 21:15, Aaron Seib wrote:
>
> Hi Glen – I like your definition but in the domain of Consumer Facing 
> Applications that includes both tethered and untethered PHRs and other 
> apps controlled by the consumer we use the term tethered in a much 
> more narrow way.
>
> A tethered PHR is what is typically encountered as a Patient Portal of 
> an EMR.  The only data that is viewable via such a portal is what is 
> created within the EMR and made viewable to the consumers’ accounts.  
> MicroSoft HealthVault on the other hand is not “tethered” to a single 
> source of data but is untethered and may receive data from multiple 
> data providers including for example data from the different EMRs used 
> by your Doctors, the several labs and yes – even the Patient Generated 
> Health Data entered by you.
>
> Like most things in the sphere of language the usage changes the 
> meaning but I have found constraining the use of tethered to mean a 
> portal that is a view into a single enterprises view very useful from 
> a policy discussion perspective.
>
> Essentially if you offer your patients a portal that is a Tethered PHR 
> and the operator of that Tethered PHR signs a BAA with you then the 
> system should be treated as you would any HIPAA covered system.
>
> An untethered Portal, where the consumer has control over what data is 
> added (via different modes of exchange) is not a HIPAA covered system 
> but falls under the regulatory requirements of the FTC.
>
> The distinction is often important.
>
> As time goes by we are seeing these lines blur but at least for now 
> they are useful in my little slice of the world.  In your example 
> below I would say that Quest is sharing your Lab results by one of the 
> modes of exchange supported by MSHV – guessing Direct?
>
> Aaron Seib
>
> NATE <http://www.nate-trust.org/>, CEO
>
> @CaptBlueButton
>
> (o) 301-540-2311
>
> (m) 301-326-6843
>
> *From:*Openid-specs-heart 
> [mailto:openid-specs-heart-bounces at lists.openid.net] *On Behalf Of 
> *Glen Marshall [SRS]
> *Sent:* Tuesday, November 17, 2015 7:38 PM
> *To:* openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] EHR, PHR, FHIR resources.
>
> Dale,
>
> A personal example may suffice...
>
> I have a Microsoft Health Vault account.  It is my PHR.  It includes 
> data that I have entered and maintain, e.g., current demographics, 
> medications, allergies, health events, visits, etc.  It also 
> automatically obtains lab results from Quest Diagnostics, which is 
> "tethered" to it.  I am hoping that my personal physician's EHR will 
> soon be able to be tethered so I don't have to keep manual track of 
> it.  In lieu of automatic tethering, though, I can import data from 
> patient portals to my regular family doctor, my urologist, 
> radiological images, blood glucose meter, etc.
>
> Glen
>
> *Glen F. Marshall*
> Consultant
> Security Risk Solutions, Inc.
> 698 Fishermans Bend
> Mount Pleasant, SC 29464
> Tel: (610) 644-2452
> Mobile: (610) 613-3084
> gfm at securityrs.com <mailto:gfm at securityrs.com>
> www.SecurityRiskSolutions.com <http://www.SecurityRiskSolutions.com>
>
> On 11/17/15 17:52, Dale Moberg wrote:
>
>     Hi
>
>     I am still refining my grip on assorted terminology that reveals
>     aspects of the “business model” contexts for discussing our use cases.
>
>     I just read the wikipedia entries for PHR and EhR (I know, but you
>     have to start somewhere), at
>
>     https://en.wikipedia.org/wiki/Personal_health_record and
>
>     https://en.wikipedia.org/wiki/Electronic_health_record
>
>     Nominally viewed, there appears to be substantial intersections of
>     the resource types (in a loose FHIR usage) found in these EhR and
>     PHR records.
>
>     At
>     https://en.wikipedia.org/wiki/Personal_health_record#EHRs.2C_PHRs.2C_patient_portals_and_UHRs it
>     is maintained that the “ownership” of the records is the primary
>     semantic contrast between the terms. Interesting.
>
>     I am particularly even more motivated in getting some information
>     about the following statement:
>
>     "There are two methods by which data can arrive in a PHR.^[1]
>     <https://en.wikipedia.org/wiki/Personal_health_record#cite_note-Tang-1>
>     A patient may enter it directly, either by typing into fields or
>     uploading/transmitting data from a file or another website. The
>     second is when the PHR is tethered to an electronic health record,
>     which automatically updates the PHR.”
>
>     Does anyone know the “BLT” pertaining to the “tethering” process?
>     Is this tethering something that is currently actually in
>     operation, or is it mainly imagined as emerging once FHIR dstu-X
>     is completed? (And maybe UMA and HEART completed also?)
>
>      (Adrian offered to help some of us with the terminology, so I am
>     taking him ( and anyone else) up on the offer!)
>
>     Dale Moberg
>
>
>
>
>
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