The University of Nebraska Medical Center announced plans today for what is believed to be the first time an academic organization has established a Web-based Personal Health Record (PHR) program for all its students. In contrast with medical records that are owned by doctors or hospitals, a PHR is owned by the patient and is part of a national effort to involve patients in their own health care.
Although there has been much discussion around the country about the use of PHRs by large corporations, it is believed that this marks the first time an academic organization has done so, and the use of a Web-based PHR program makes it even more unique.
Health and Human Services Secretary Michael Leavitt has made creation of a portable electronic medical record one of the key priorities of his agency, not only for emergency preparedness but also for routine medical care. As part of its emergency preparedness efforts, all UNMC students will be given the opportunity to enroll in the voluntary program.
Under the program, students will access a password-secured Web site that provides the electronic format for creation of their health record. An Omaha based company, HDC 4Point Dynamics, is partnering with UNMC to operate and maintain the system which was originally proposed by the Center for Biosecurity at UNMC.
A key feature of the system is that each student will have control of his/her own PHR. They will establish and maintain their personal and family health information, and the individual can decide if their PHR can be accessed by health care professionals and for what period of time. The approach facilitates the transportation of essential health information when the student transitions to the private sector or continues education at another institution, as commonly occurs when medical students begin their residency training.
Experts have estimated that electronic medical and health records could save the U.S. up to $45 billion in health care costs, said Henry Zach, president of HDC 4 Point Dynamics.
“The situation our students face is representative of one of the biggest problems in health care today,” said Steven Hinrichs, M.D., professor in UNMC’s Department of Pathology and Microbiology and director of the Nebraska Center for Biosecurity. “When our students move between training sites, their records remain in doctors’ offices and hospitals. Using the personal health record approach, the medical information such as their vaccination record moves with them and information is accessible when needed.”
The PHR contains nine different information categories – demographics and insurance, related parties and emergency contacts, patient and family history (chronic conditions), lifestyle/habits/directives, allergies, immunizations, medications, providers, and hospital/clinic visit information and vitals.
The PHR is accessible from any place at any time using a browser with Internet connection. Health care providers can access with patient permission and update their relevant medical and visit information. In the near future, students, providers and laboratories will be able to enter lab results. The system will identify the source of the new data.
Dr. Hinrichs said that both the government and private sector are looking for ways to empower the patient and give them secure access to their medical records. “The challenges are very significant and student populations have been largely overlooked,” he said. “The federal and state governments are strongly encouraging these type of efforts, but the challenges are very significant and we need successful pilot projects to lead the nation into the future.
“The biggest obstacle is getting different computer health systems to interact with each other. It is called interoperability. There are hundreds of systems out there, but they typically only communicate within a single health system. It’s fine if you stay in the same system, but what if you are a graduate student or nursing student and have to move two or three times during your training?”
Because of the complexities involved in integrating so many different computer health systems, Dr. Hinrichs said the decision was made to utilize a Web-based application. “Everyone is looking for Nirvana and the security challenges of the Internet are greater, but the portability is optimal,” he said. “We expect to learn a great deal from this project.”
“I’m excited to be part of this groundbreaking project,” said Dan Connealy, immediate past president of the UNMC Student Senate and a former student regent for the University of Nebraska. “The college students of today grew up using computers and the Internet. It should be easy for all of us to be comfortable working with the PHR.”
Current UNMC Student Regent Jonathan Henning said: “Considering the cost of distributing health information, a centralized PHR is a solution that can transform this burden in the U.S. health care system. I’m excited to participate, and I think this is a great opportunity for UNMC students to be a part of a cutting edge solution to a nationwide problem.”
Dr. Hinrichs agrees. “We think our students are the perfect people to test the system,” he said. “After they learn it, they can go out and teach their teachers and parents and older health professionals how to use it. It’s a complete reversal of the classic role of teacher and student – our students are going to lead their instructors into the next generation.”
Zach said PHRs can save money and increase patient safety, by avoiding duplicative tests or prescriptions, avoiding potentially harmful drug interactions and reducing medical errors.
“Physicians do a good job with the information they have,” Zach said. “The problem they have is that sometimes the information is missing, incomplete or bad. If a patient comes in with a PHR, the physician has already saved 20 minutes by not having to find information that had been collected earlier, such as laboratory test results. We are excited that the university had the vision to work with us in creating a critical mass of participants to make this a reality.”
The Center for Biosecurity is especially interested in PHRs, Dr. Hinrichs said, because college campuses would be a prime location for pandemic influenza to hit. The recent outbreak of the mumps is another example of an illness that could spread rapidly in a college environment.
“Parents continue to worry about their children when they are away at college,” Dr. Hinrichs said. “The PHR could reduce their anxiety. They could rest a little easier knowing that if anything happened to their student, health professionals would be able to tap into the PHR and obtain the student’s emergency contact information, allergies and medications.”
UNMC Chancellor Harold M. Maurer, M.D., said the PHR program for students is just another example of the university being proactive in preparing its students for the future. “This program is providing an advanced learning experience,” he said. “Four major corporations have recently announced plans to provide electronic health records to their employees. We are pleased to work with a Nebraska corporation to make this happen inside the university.”
UNMC is the only public health science center in the state. Its educational programs are responsible for training more health professionals practicing in Nebraska than any other institution. Through its commitment to education, research, patient care and outreach, UNMC has established itself as one of the country’s leading centers in cancer, transplantation biology, bioterrorism preparedness, neurodegenerative diseases, cardiovascular diseases, genetics, biomedical technology, ophthalmology and arthritis. UNMC’s research funding from external sources is now nearly $80 million annually and has resulted in the creation of more than 2,400 highly skilled jobs in the state. UNMC’s physician practice group, UNMC Physicians, includes more than 460 physicians in 50 specialties and subspecialties. They practice primarily in The Nebraska Medical Center, UNMC’s teaching hospital. For more information, go to UNMC’s Web site at www.unmc.edu.