[Openid-specs-heart] EHR, PHR, FHIR resources.
Glen Marshall [SRS]
gfm at securityrs.com
Wed Nov 18 03:56:18 UTC 2015
Aaron,
With Quest you enter your ordering physician's PIN, provided by the
physician's office. Then, for any orders made by the physician, the
results are forwarded to your MSHV as well. I don't know the underlying
records that are sent.
When I access my 5 "tethered" physician portals I can download a
portable copy (a CCR) that I can upload to MSHV to achieve some sense of
unification. Similarly, I can upload radiological images and blood
glucose device data. No such luck with my local pharmacy portal nor my
mail-order pharmacy portal, though. My Medicare parts A&B claims portal
doesn't communicate with Part D. I'd like to integrate my dentist and
periodonist records, but they lack an online portal or image storage.
Massage therapy and my exercise at the local YMCA are out of scope. And
I'd *love* to be able to register/post my privacy preferences, consents,
durable POA, and authorized representatives' IDs in a common location.
Simplicity remains elusive. And I'm glad to not have another chronic or
acute illness, knock on wood.
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 22:35, Aaron Seib wrote:
>
> Exactly the issue that NATE has in its sites.
>
> Imagine if you will, after authenticating into the Tethered Portal you
> could provide your MSHV Direct address and instruct (authorize) the
> Institution to auto-forward any new content that it makes viewable via
> the portal to your consumer controlled application.
>
> How did you set it up to work with Quest?
>
> Aaron Seib
>
> NATE <http://www.nate-trust.org/>, CEO
>
> @CaptBlueButton
>
> (o) 301-540-2311
>
> (m) 301-326-6843
>
> *From:*Glen Marshall [SRS] [mailto:gfm at securityrs.com]
> *Sent:* Tuesday, November 17, 2015 10:20 PM
> *To:* Aaron Seib; openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] EHR, PHR, FHIR resources.
>
> 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 <mailto:gfm at securityrs.com>
> www.SecurityRiskSolutions.com <http://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
> <mailto: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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