NoMoreClipboard is combining its personal health record and provider data from health information exchanges to build a Blue Button for consumers.
They are also helping health information exchanges stay in business in the process.
Over the last two years, NMC has used grant money from the Office of the National Coordinator to build a bridge between provider data from health information exchanges and personal health records.
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ONC’s vote of confidence helped NMC persuade healthcare systems to participate in pilot projects. NMC worked with a critical access hospital, a rural clinic and a cardiology practice to get EHR data into patients’ hands.
The other force driving doctors and hospitals to NMC’s door is approaching deadlines for meaningful use 2. MU2 requires eligible providers and hospitals to allow patients to “view online, download and transmit their health information” within four business days of a provider getting the information or within 36 hours after discharge from the hospital. Providers have to get 5 percent of patients to access their data this way.
Jeff Donnell, president of NoMoreClipboard, said that providers are coming to HIEs around the country and asking for help in meeting this requirement.
“Most EHR vendors have some sort of tethered portal but they want an arm and a leg for it, and it’s not good for patients because they will have five different portal accounts to manage,” Donnell said.
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Customer expectations are also pushing providers into the digital era.
“We’re hearing more and more from providers that patients are telling them, ‘Sorry, I’m going to go somewhere else because you don’t have what I need,'” Donnell said. “Docs may not embrace this stuff but they’re really smart people, they know time has finally come.”
NMC has worked with all five of Indiana’s health information exchanges to test PHRs with various patient populations. Hospitals, doctors offices, safety net clinics and a regional lab all participated in the pilot projects.
As with many health data projects, the hard part was not the technology.
Donnell said that his team has learned that the challenge is doing the policy work and stakeholder education. It takes time to address the “millions of questions, fears and concerns” that doctors, office managers and nurses have.
“If an HIE came to me and said, ‘We have $1 million to build a patient portal,’ I would tell them to spend $100,000 of that money over six months to do policy work, listening sessions and stakeholder education,” he said. “You can’t just have one meeting and say, ‘Yep, we addressed that.'”
Donnell said that working with the five HIEs in Indiana illustrated the variety of governance models and data-sharing rules.
“We didn’t even contemplate sharing data with patients when these rules were put in place,” he said. “Some groups have a centralized governance model and some have individual agreements with every provider.”
When deciding what provider data to port over to a personal health record, HIEs and providers have to answer questions like:
- Will we share doctor’s notes, radiology reports, lab reports?
- Are there certain things that we won’t share?
- Do we share abnormal test results?
- Do we share STD tests?
- Do we put a 72-hour delay on the transfer of information so a doctor can get a look first?
Donnell said that NMC is building a patient portal with HIE in Kansas and is talking with more than 12 other HIEs around the country. The company is planning a July 16 webinar with the National e-Health Collaborative on lessons learned from the ONC project