The first in a four part series integrating patient advocacy, care coordination, personal health records and other HIT components. For Nurses, Other Paraprofessionals
2. Syllabus1. Defining a persons needs and the evolving National
Health Information Infrastructure1. Defining an emerging Health
Information Technology within the context ofthe US HealthCare
System2. An example for you1. Real Use Case 20112. Samples of
Levels of Support Based on Functional Status3. Personal Health
RecordsSelectionComponentsSecurity1. Process4. A Transition Model5.
Why We Do It10/24/20112 3. Untangled Healthcare Patient Advocacy
Series Part One: Defining a Persons Needs Defining a persons needs
Defining an emerging Health Information Technology within the
context of the US HealthCare System10/24/2011 3 4. Advocate and
Instruct10/24/2011 4 5. Instruct "Go to the people, live with them,
learnfrom them....Start with what they know, build with whatthey
have...."Lao Tzu10/24/2011 5 6. Life CycleBirth Death Education
Loss of IllnessWork Chronic Work Illness Illness10/24/2011 6 7.
Advocacy by Patient Type1. Healthy (consumer - retain customer
goal)2. Worried-well (counsel)3. Self-limited sick (do nothing
unusual)4. Catastrophic sick (coordinate episode)5. Asymptomatic /
Minor chronic conditions 1. Patient education and self-advocacy
with monitoring6. Symptomatic / Major chronic conditions 1. Care
Management - reverse / slow progression / maintain health7. Hospice
/ end-of-life 1. Care Management - maintain / comfort10/24/2011 7
8. Episodic CareDiagnosisHospitalizationRehabilitationReturn to
Community Start time Process Time Stop Time10/24/2011 8 9. Chronic
Continuum of CareAssessMonitorPlan CoordinateEducate10/24/20119 10.
Acute Care Hospital Advocating the Mess Sub-AcuteFacility Acute
Rehab.Facilityintense illnessshort term medical manage pulmonary
rehab. repeat1st rehab. chronic vent. dependentrequires nocturnal
management SNF custodialLong Term1st rehabDay Rehab. careCase
ManagerCare safe at nightFacility home bound with services post IP
or sub acuteor first rehab Home Health O2 etc.. mild to moderate
post rehabCare disease independent or fitness supervisedprograms
referral to ISNOut PatientHome CareFacilityDME Residential Living
Fitness Center with MaintenanceYMCA etc..program patient / family
Patient and Familyprovider needs Enter System LEGEND10/24/201110
11. Acute Care Hospital Advocating for What? Sub-AcuteFacilityAcute
Rehab. Facilityintense illnessshort term medical manageAnd Care Is
Continuous And Payment rehab. repeat pulmonary Happens1st rehab.
Insurance dependent chronic vent.No Gaps In Treatmentrequires
nocturnal management Commercial No Gaps in Meds SNFLong TermPublic
custodialAnd Care has Continuity 1st rehabDay Rehab. careCare
Safety Net Case ManagerHealthcareatProviders Share safe night
Facility Health Insurance Exchange Care Plan Charity bound And Care
has Qualityhome Selfwith servicesPay Healthcare Providers ShareSame
Evidencefirst sub acute post IP or or BasedrehabHome Health O2
etc..post rehabGuideline mild to moderateCaredisease independent or
fitness supervisedprograms referral to ISN Out Patient Home
CareFacility DME Residential Living Fitness Center with
MaintenanceYMCA etc..program patient / familyPatient and
Familyprovider needsEnter System LEGEND10/24/2011 11 12. Untangled
Healthcare Patient Advocacy Series Components of National Health
Information Infrastructure E-HR Electronic Health Records Capable
of exchanging data between disparate systems across the USA
Electronic Medical Records Capable of exchanging data within an
isolated organizational entity e.g. Duke Medicine P-HR Personal
Health Records A subset of critical information managed by patient
HIE Health Information Exchange The communications technology,
security and privacy standards, governance structure for passing
information among members. Requires patient consent.10/24/2011 12
13. E-HealthcareThe Evolving National HITMaking sense of it all
SystemJeffrey Harris Untangled HealthcareFrom Confusion To Fusion
(we hope?) Patient recall (interview) Digital shared continuous
history Paper records Magical transfer of data across vast Manual
processes with formsdistances including pictures, treatments,
diagnosis, test results X-ray film and Fluoroscopy Computers
converting data to information Microscopes and Cell Counts shared
with the service providers who Postal Service include patient and
family as active Telephones component of treatment team Fax
Machines Shared accountability for well-being Human ComputersWho
are youWe are I am morepeople?better healthy.,What are you informed
knowledgeable, doing?motivated and I cant remember accountable all
of my doctorsand why myparents passed away?Past
PresentFuture10/24/2011 13 14. 10/24/2011 14 15. Graphic
Representation of National Initiative Data Exchange Illustrated Non
Integrated SystemIntegrated System with e-HRPHRPCMHSingle
PracticeEMR SiloSpecialistEHRVarious LabsCommunication
BarrierEHRLIMS Local hospital affiliate PACSEHRfImagingSure
HospitalSystemScriptsPharmacyLocal PharmacyHealth Info
Exchange10/24/2011 15 16. Syllabus1. Defining a persons needs and
the evolving National Health Information Infrastructure1. Defining
an emerging Health Information Technology within the context ofthe
US HealthCare System2. An example for you1. Real Use Case 20112.
Samples of Levels of Support Based on Functional Status3. Personal
Health RecordsSelectionComponentsSecurity1. Process4. A Transition
Model5. Why We Do It10/24/2011 16 17. Jeffrey Harris Untangled
Healthcare Jeffrey Halbstein-Harris Untangled Healthcare Assisting
communities to monitor and improve healthcare 919 627-5038 Cell
919-779-7368 Office Fax 888 783-6178 (Jeffrey Harris) email:
[email protected] LinkedIn:
http://www.linkedin.com/in/untangledhealth Blog:
http://www.untangledhealth.com/ Website:
http://www.untangledhealthcare.com/ Twitter:
http://twitter.com/UntangledHealth Slide share:
http://www.slideshare.net/jeffharris7510/24/2011 17
