Outline
Personalizing Health Care
Getting Patients Connected – Online
Paul Tang, MD
Palo Alto Medical Foundation
¾ Traditional disease
management
on first
¾ Personalizing health care
¾ Bringing patients on-board
¾ Who’s
Traditional Disease Management
“Protocol Driven”
Traditional Health Care
Disease Condition
Managing Disease
Action Plan
Who, then What?
Personalizing Health
Role for a Personalized Health
Record
Jim Collins, Good to Great
© Paul Tang, 2008
1
PAMFOnline Disease Management
Patient-Centered
My Risk Profile
My Disease Condition
My Health Risk Assessment
(
(HRA)
)
Integrated with the EHR
My Agenda
My Action Plan
From Patient
From EHR
Providing Self-Management
Tools
A Personalized Health Record
© Paul Tang, 2008
2
PAMFOnline Survey Results
Self Efficacy
¾
¾
¾
¾
9
¾
“The test charts are a eye opener and makes me pay
more attention to health management issues.”
“Getting direct access to lipid panel results incented me
p a low-fat diet ((which I have maintained p
pretty
y
to adopt
well for a year now).”
“I feel more confident!”
“I see myself as more accountable for my health.”
“I lost weight to get the overweight designation off my
record.”
Change in Health Behavior
Proving Whether It Works
Specifically Due to Using PAMFOnline
A Randomized Controlled Clinical Trial
¾ Funded
50%
45%
40%
35%
30%
25%
20%
Messaging
15%
by the Agency for Healthcare
Research and Quality
¾ 400 diabetic p
patients to be recruited ((200
intervention, 200 controls)
¾ Outcome measures:
ƒ
10%
ƒ
5%
0%
Made a
change
© Paul Tang, 2008
Made a
Thought
change but
about
did not
changing
keep it
No
Not ready
difference to change
Does not
apply
ƒ
ƒ
HbA1c, BP, lipids, wt, microalbumin
Self-management behavior
Patient and provider satisfaction
Utilization
3
Summary
Connecting for Better Health
¾ Need
to put patients (and their caregivers) on
the health care team
ƒ
ƒ
Break through the “glass ceiling” of health care
delivery effectiveness
Leverage an untapped resource (patients and their
family caregivers)
¾ Personalizing
health care is key to engaging
patients and transforming healthcare delivery
¾ EHRs and PHRs are essential technologies for
health care
© Paul Tang, 2008
4