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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>
<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 21:15, Aaron Seib wrote:<br>
</div>
<blockquote
cite="mid:01e801d121a7$05274610$0f75d230$@nate-trust.org"
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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">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.<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">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.<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>
<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. <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>
<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. <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>
<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.<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>
<p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The
distinction is often important. <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>
<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?<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">
Openid-specs-heart
[<a class="moz-txt-link-freetext" 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 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">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>
<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>
</div>
</blockquote>
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