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Aaron,<br>
<br>
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.<br>
<br>
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. <br>
<br>
Glen<br>
<div class="moz-signature">
<p><b>Glen F. Marshall</b><br>
Consultant<br>
Security Risk Solutions, Inc.<br>
698 Fishermans Bend<br>
Mount Pleasant, SC 29464<br>
Tel: (610) 644-2452<br>
Mobile: (610) 613-3084<br>
<a class="moz-txt-link-abbreviated" href="mailto:gfm@securityrs.com">gfm@securityrs.com</a><br>
<a class="moz-txt-link-abbreviated" href="http://www.SecurityRiskSolutions.com">www.SecurityRiskSolutions.com</a></p>
</div>
<div class="moz-cite-prefix">On 11/17/15 22:35, Aaron Seib wrote:<br>
</div>
<blockquote
cite="mid:01fb01d121b2$329f6fe0$97de4fa0$@nate-trust.org"
type="cite">
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<p class="MsoNormal"><a moz-do-not-send="true"
name="_MailEndCompose"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Exactly
the issue that NATE has in its sites. <o:p></o:p></span></a></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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. <br>
<br>
<o:p></o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">How
did you set it up to work with Quest? <o:p></o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<div>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Aaron
Seib<o:p></o:p></span></p>
<p class="MsoNormal"><a moz-do-not-send="true"
href="http://www.nate-trust.org/"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif"">NATE</span></a><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">,
CEO<o:p></o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">@CaptBlueButton</span><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(o)
301-540-2311<o:p></o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(m)
301-326-6843<o:p></o:p></span></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
</div>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<div>
<div style="border:none;border-top:solid #B5C4DF
1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b><span
style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">From:</span></b><span
style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">
Glen Marshall [SRS] [<a class="moz-txt-link-freetext" href="mailto:gfm@securityrs.com">mailto:gfm@securityrs.com</a>] <br>
<b>Sent:</b> Tuesday, November 17, 2015 10:20 PM<br>
<b>To:</b> Aaron Seib;
<a class="moz-txt-link-abbreviated" href="mailto:openid-specs-heart@lists.openid.net">openid-specs-heart@lists.openid.net</a><br>
<b>Subject:</b> Re: [Openid-specs-heart] EHR, PHR, FHIR
resources.<o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal" style="margin-bottom:12.0pt">Aaron,<br>
<br>
Thanks for the clarification. I thought it was systems that
were tied to one another, not the patient being tethered. <br>
<br>
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.<br>
<br>
Glen<br>
<br>
<o:p></o:p></p>
<div>
<p><b>Glen F. Marshall</b><br>
Consultant<br>
Security Risk Solutions, Inc.<br>
698 Fishermans Bend<br>
Mount Pleasant, SC 29464<br>
Tel: (610) 644-2452<br>
Mobile: (610) 613-3084<br>
<a moz-do-not-send="true" href="mailto:gfm@securityrs.com">gfm@securityrs.com</a><br>
<a moz-do-not-send="true"
href="http://www.SecurityRiskSolutions.com">www.SecurityRiskSolutions.com</a><o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">On 11/17/15 21:15, Aaron Seib wrote:<o:p></o:p></p>
</div>
<blockquote style="margin-top:5.0pt;margin-bottom:5.0pt">
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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.</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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.</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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. </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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. </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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.</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The
distinction is often important. </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">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?</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<div>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Aaron
Seib</span><o:p></o:p></p>
<p class="MsoNormal"><a moz-do-not-send="true"
href="http://www.nate-trust.org/"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif"">NATE</span></a><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">,
CEO</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">@CaptBlueButton</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(o)
301-540-2311</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(m)
301-326-6843</span><o:p></o:p></p>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
</div>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
<div>
<div style="border:none;border-top:solid #B5C4DF
1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b><span
style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">From:</span></b><span
style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">
Openid-specs-heart [<a moz-do-not-send="true"
href="mailto:openid-specs-heart-bounces@lists.openid.net">mailto:openid-specs-heart-bounces@lists.openid.net</a>]
<b>On Behalf Of </b>Glen Marshall [SRS]<br>
<b>Sent:</b> Tuesday, November 17, 2015 7:38 PM<br>
<b>To:</b> <a moz-do-not-send="true"
href="mailto:openid-specs-heart@lists.openid.net">openid-specs-heart@lists.openid.net</a><br>
<b>Subject:</b> Re: [Openid-specs-heart] EHR, PHR,
FHIR resources.</span><o:p></o:p></p>
</div>
</div>
<p class="MsoNormal"> <o:p></o:p></p>
<p class="MsoNormal" style="margin-bottom:12.0pt">Dale,<br>
<br>
A personal example may suffice...<br>
<br>
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.<br>
<br>
Glen<o:p></o:p></p>
<div>
<p><b>Glen F. Marshall</b><br>
Consultant<br>
Security Risk Solutions, Inc.<br>
698 Fishermans Bend<br>
Mount Pleasant, SC 29464<br>
Tel: (610) 644-2452<br>
Mobile: (610) 613-3084<br>
<a moz-do-not-send="true" href="mailto:gfm@securityrs.com">gfm@securityrs.com</a><br>
<a moz-do-not-send="true"
href="http://www.SecurityRiskSolutions.com">www.SecurityRiskSolutions.com</a><o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">On 11/17/15 17:52, Dale Moberg wrote:<o:p></o:p></p>
</div>
<blockquote style="margin-top:5.0pt;margin-bottom:5.0pt">
<div>
<p class="MsoNormal">Hi<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">I am still refining my grip on
assorted terminology that reveals aspects of the
“business model” contexts for discussing our use cases.<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">I just read the wikipedia entries for
PHR and EhR (I know, but you have to start somewhere),
at<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"><a moz-do-not-send="true"
href="https://en.wikipedia.org/wiki/Personal_health_record">https://en.wikipedia.org/wiki/Personal_health_record</a>
and<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"><a moz-do-not-send="true"
href="https://en.wikipedia.org/wiki/Electronic_health_record">https://en.wikipedia.org/wiki/Electronic_health_record</a><o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">Nominally viewed, there appears to be
substantial intersections of the resource types (in a
loose FHIR usage) found in these EhR and PHR records.<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">At <a moz-do-not-send="true"
href="https://en.wikipedia.org/wiki/Personal_health_record#EHRs.2C_PHRs.2C_patient_portals_and_UHRs">https://en.wikipedia.org/wiki/Personal_health_record#EHRs.2C_PHRs.2C_patient_portals_and_UHRs</a> it
is maintained that the “ownership” of the records is the
primary semantic contrast between the terms.
Interesting.<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">I am particularly even more motivated
in getting some information about the following
statement:<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">"There are two methods by which data
can arrive in a PHR.<sup id="cite_ref-Tang_1-1"><a
moz-do-not-send="true"
href="https://en.wikipedia.org/wiki/Personal_health_record#cite_note-Tang-1">[1]</a></sup>
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.” <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">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?) <o:p></o:p></p>
</div>
<p class="MsoNormal"> <o:p></o:p></p>
<div>
<p class="MsoNormal"> (Adrian offered to help some of us
with the terminology, so I am taking him ( and anyone
else) up on the offer!)<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal">Dale Moberg<o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<div>
<p class="MsoNormal"> <o:p></o:p></p>
</div>
<p class="MsoNormal"><br>
<br>
<br>
<br>
<br>
<o:p></o:p></p>
<pre>_______________________________________________<o:p></o:p></pre>
<pre>Openid-specs-heart mailing list<o:p></o:p></pre>
<pre><a moz-do-not-send="true" href="mailto:Openid-specs-heart@lists.openid.net">Openid-specs-heart@lists.openid.net</a><o:p></o:p></pre>
<pre><a moz-do-not-send="true" href="http://lists.openid.net/mailman/listinfo/openid-specs-heart">http://lists.openid.net/mailman/listinfo/openid-specs-heart</a><o:p></o:p></pre>
</blockquote>
<p class="MsoNormal"> <o:p></o:p></p>
</blockquote>
<p class="MsoNormal"><o:p> </o:p></p>
</div>
</blockquote>
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