I have included what I hope to provide is some extensive information on the new Health Vault. If you read this blog regularly, you know I am a big advocate of privacy, and for many good reasons. I hand it to Microsoft for taking a jump into the records business, and thus this morning I set up my account to go through the motions and see first hand how it works.
One of my biggest concerns is privacy and who has access...as we all know sometimes information is perhaps not used for the interest of good health care, but rather for financial gains and additional data mining information that has the potential to either deny or hinder our process for obtaining both health care and insurance coverage. My personal opinion here would be to ensure this does remain a "personal" page and hopefully no access from insurance companies to gain information would be available; however, if one wanted to include information from an insurance company if they decided to make documents available, it would be up to you to be able to make that decision on whether or not you want to add this information to your records, and the realization of this is to cut data mining from the purpose of online records and keep the main purpose of this effort in the forefront...better health care and information for the patient..without dollar signs attached for data mining.
I have reviewed and looked at many of the on line health records and I too have had big reservations about where I want any of this information posted. The first step of the process is to have a "Live ID" from Microsoft, and if you currently have a Live ID, and the password is not strong enough, it will need to be updated.
Here's the news article and you can continue below for some additional screen shots and information added based on my observations and creating an account. BD
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SEATTLE (AP) -- Microsoft Corp. launched a Web site Thursday for managing personal health and medical information, jumping into an industry whose digital future is clouded by privacy worries. Users can dole out access -- in the form of e-mailed invitations -- to different slices of their private health data to doctors, family members and other people they trust as the need arises.
Microsoft's Nolan said gaining consumers' trust is a potential problem, one the company tried to address by spelling out exactly what data would be shared each time the user connects to a new application or gives someone new permission to see a record.
So far, Microsoft said applications from the American Heart Association, American Lung Association and other organizations are in the works, and devices including blood glucose monitoring systems made by Johnson & Johnson will be able to upload data into the system.
Microsoft said CapMed, which already markets personal health record tools, will create an application for HealthVault, as will Kryptic Corp., whose program will help doctors send and receive information from HealthVault without having to switch from technology they already use
And some of the best sources of comprehensive health records data -- major insurance providers, many of which already offer personal health records tools -- haven't agreed to build applications that work with HealthVault.
Link to Health Vault: http://www.healthvault.com/
Continued Coverage and Information
After creating my account, I was sent to a page to agree to the terms of use and I also took the time to read the privacy policy. I didn't see anything out of the ordinary here as every site these days has the same privacy policies posted. In any rate, to continue, you need to accept the terms after logging on with a Live ID. I already had one I used through a Hotmail account.
This screen allows you to see how thing work and to view some of the health partners contracting with the site. There are some names on the list you will probably recognize.
More than one record can be added, for example you might want to use the site for the entire family. There are levels of security with the "custodian" having the ultimate access and permissions granted. The custodian has the say so over all. The screens are nicely designed to allow for quick and easy access. All the screens will be blank as there is no data added yet.
I'm thinking I also might want to add my dog...he's family too. 
This is the "create a new record" screen, where other members can be added. 
This is the document manager on the site. You can upload documents from your computer. If you have worked with any web based email or even picture sharing sites, you will get the hang of this immediately. A window opens so you can search your computer and select items to upload.
Now for another neat feature ....search....I can search for health information by keyword, so what I have done on the following screens was to search for the word "headache". 
After my search is complete, I was presented with related articles, Web results, and the right hand column has some "sponsored results", in other words the site is add supported and will show books available about headaches from Amazon in this case, so I can review and look up any published material that might be available for purchase. Below the ad section for books, there are several other sponsored links to sites that offer additional information and potential products that would relate to headaches, such as pain relief, nasal sprays, etc.
The Scrapbook feature
This is something I found very unique and interesting. Let's say you have done some research on headaches or want to save the link for later reference. Do we want to use the more than likely over crowded "favorites" link on the browser...I don't know about you, but mine keeps growing and finding information in favorites can be a chore too.
The scrapbook will save this information for you and allow you to create a "tag". In my scrapbook now I have a link called "headache". I can use this same tag again to categorize another article I have researched, so now I have all my 'headache" information in one convenient spot. Very cool....
I can also send articles from my scrapbook to others....
I think this is going to be a very interesting project as it evolves. I do recommend to everyone to fully read all the instructions and privacy notices before you start. If you have not been active for over 20 minutes, the system will automatically log you out for security reasons. Most online banking does this as well.
Once I have signed back in I am presented with the dashboard controls for my account at the Health Vault.
I will be doing more testing with the site and thus far this looks to be the best attempt at online records I have seen. Again, if the goal of better health care and privacy is maintained here without being compromised to data mining for profit, I think Microsoft could really be on to a potential solution. Right now this is beta and if you do sign up for an account and have suggestions, there is a place for that as well.
The site through partners has the ability for you to share your records with your physicians as well as signing up for health coaches, and again research those thoroughly before jumping in feet first to make sure this is what will be in your best interest. Some health coach companies are subsidiaries of insurance companies and you need to read the fine print once you share the records, as to where they go from there.
You can also cancel your account at any time, but it is held for 90 days in case you decide otherwise and want to reinstate your account. After the 90 day period, you will need to start from the beginning. If you feel you have shared something and want to remove it, you can do that too, but just remember if the other party has already accepted and obtained a copy of the information you shared, that cannot be rescinded if they have created a local copy for their files...again, just be sure of what you intend to share and with who.
And one more thing, don't forget about the help files on the site...there's a lot of good information on "how to" with the various screens of the site.
Again, this appears to be the best online approach I have seen to date. BD
http://biz.yahoo.com/ap/071004/microsoft_healthvault.html?.v=1
As a practicing physician, I'm really excited about this application and have signed up for a personal account. My plan is to start enrolling my patients with the hope of consolidating their medical data.
ReplyDeleteI found however that the application did not have a place for me to enter my past medical history, medication lists etc. I think, for this application to work for my patients, this feature needs to be in place. Perhaps this feature already exists. If this is the case, it needs to be more obvious to the user. I know this is in beta, so I'm willing to wait. My hope is that the Health Vault is a true PHR.
MArk Singh MD
www.clinicore.blogspot.com
Thank you for your comments and I think this is only the start and a potentially a real good idea as there is no profit in this and advertising is paying the way too.
ReplyDeleteThanks for the tutorial. I will check it out and see if it will work for patients. Even in an educated community, I think most patients will not take the time to manage their health this way unless it is easy, quick and intuitive...and as you have stressed, safe.
ReplyDeleteI am appalled by the physicians above who seem to think that giving patients control over their own healthcare records is a GOOD IDEA.
ReplyDeleteIt boggles the mind. Truly. Are all your patients honest? Do they all have perfect memories? Can you trust them to leave your notes intact? Even the ones they may not like or may not agree with?
Come on, people. Use your heads, here! The user has too much control over their health records, please please please DO NOT use this as an official patient record database. The ability to abuse the system egregiously is staring them in the face, 24/7.
This is a horrible idea. Think it through before you jump in with both feet!
Thanks to all for your comments. I think this is going to be pretty exciting to see how this evolves. This is not going to be a replacement for the records kept by a practice, but I believe more information that can supplement and help provide more information, i.e. a new patient that can provide some prior information or perhaps a copy of a prior lab, etc. that can help with an overall treatment plan, and less work for the physician in having to document and extract everything themselves from the start of the patient relationship.
ReplyDeleteThere's a much easier and more private way for consumers to store their health log... just type it out with a text editor. (See more here.) I'm not sure what the overriding benefit of Microsoft's approach is, and there are plenty of obvious drawbacks.
ReplyDeleteThere is a HUGE gap between what patients understand about their health information and what clinicians actually need to work with them. Busy clinicians do not have the bandwidth to interpret/absorb the multitude of ways patients currently relay their information - mostly verbal, from memory, lucky to get various scraps of paper via a "text editor". By far, one of the advantages of Health Vault is standardizing the organization and display of health information, so these artifacts can be efficiently used in clinical settings. (Why do you think they still make you fill out "their" form, even if you bring in a printed PHR?)
ReplyDeleteAnother advantage of a standardized PHR is that it teaches patients which health information is most important to track. If patients can fill out and maintain a well-designed PHR they will be in a very good position to deal with most health issues that may arise. This is better than learning what info to track "the hard way."
Finally, I find RJS's opinion to be very naive - as if there is currently some "golden" source of health information other than patients themselves. Most of what gets entered into EMRs today comes directly from the clipboard filled out by patients in the waiting room. They already largely control which information their clinicians have.
Patients should have the right to share whichever information they see fit - and also the responsibility to live with the consequences of their decisions.
True, I agree patients should have the final say so in what is and what is not shared. If the Health Vault continues to evolve in this area then it will be seen as a success as this is the precedence being established here. I also understand the need for good reliable clinical information too. I do hate those paper clipboards too and if we had some sort of a universal questionnaire whereby the basics were covered, that would be a huge help too, then the clinician would be a step ahead. I would much rather have something that covers the basics and then have the availability to add to it rather than a paper form that makes me start from scratch every time.
ReplyDeleteI have been on the PC for 45 minutes now to answer the question: How to share your healthvault information with Web sites and doctors? I only found these answers: 1. You can only share your healthvault info with specific web sites that healthvault has choosen. Specifially about a dozen, but is that it? What if I want to share it with another website of my choice? 2. Doctors like I have to create an account, ask the patient to let me view their records, and only read? What if I want to keep a record of their data? Afterall, I am their doctor and I want to keep a record of their visit and past data as well for follow up and homework. Healthvault is definately not the solution in my view because MS Healthvault is the true owner of this record and not the patient or the doctor. Please correct me if I am wrong.
ReplyDeleteTrinh, MD
Well let me see if this helps answer the question and maybe sheds a little light. It's somewhat the cross road where electronic medical records (EHR) and personal health records (PHR) overlap or cross if you will. As a physician, you would want some type of electronic records to be the "official" records for your patient with medically credible information in the chart, especially when having to refer or involve other physicians with the patient's care. The Health Vault is more directed toward the patient PHR in giving them a place to store their records. Now if you were using an EHR that let's say created a simple physical for example purposes, you could more than likely export the document to a Word format or pdf, and then opt to share this report with your patient. You would decide what portions of the chart you would want to share, which could be all if you wanted. In other words, using a program will store patient data in a data base and to get the information to a format where the patient can read and reference, a document would need to be generated from the program. All EHR programs have various levels of pretty automated and simple reports you can create with a couple clicks from the patient chart, so this part is fairly simple to do.
ReplyDeleteI hope that makes a little sense here as it is more of a PHR and not an EMR or EHR for complete charting as the patient can add information too, so you end up with a bit of both, health records shared by the physician and information the patient wants to share with you, and those types of documents can usually be added to a chart as well with an EMR or EHR with a document manager that ties and connects all of this to the official chart. Hope this makes a little sense here for you.
Electronic Medical Records system provides benefits such as storing and sharing of patients’ health records ensuring the privacy and confidentiality of patients’ information. This wipes out all the errors, associated with the conventional paper based system. The EMR collects and stores the patients’ health information data from all the sources like hospitals, laboratories, healthcare professionals, pharmacies and insurance companies etc.
ReplyDeleteSimilar to Microsoft, there are several reliable software that handle electronic health records. This kind of system is needed to make transactions like referrals and prescriptions easier for the patient.
ReplyDeleteAlso, electronic medical records allow patients to participate in forums and discussions related to their medical interest. Such would be helpful to gain sufficient knowledge about their condition and the possible approaches to their case.
A lot of people are now excited to try this technology. I'm positive that this breakthrough would help a lot of people.