- The Office of the National Coordinator for Health IT (ONC) has updated its Patient Engagement Playbook to include information about integrating patient-generated health data (PGHD) into patient care, the agency said in a public email announcement.
PGHD is health data produced by the patient and can include data from mHealth apps, wearable devices, and other remote patient monitoring systems. PGHD can also include patient and family health histories and other data patients can recall and enter into the patient portal.
Those PGHD technology sources have considerably altered the way in which healthcare professionals interact with this data. Prior to ubiquitous health IT adoption, healthcare professionals had to manually elicit PGHD from their patients. The use of wearables and other mHealth tools has created more PGHD and opened some roads (albeit littered with roadblocks) for collecting and using PGHD.
“Using technology, patients can also share information that’s critical for health care decision-making but often too time-consuming or cumbersome for providers to gather — like family medical histories,” the ONC Playbook explained. “What’s more, patients can provide this data from home, so that providers can maximize precious office visit time.”
The EHR has also presented opportunities for organizations to organize and make sense of patient data. Aggregating all patient data into one platform can help providers close care gaps and appreciate a holistic view of patient health.
Benefits to PGHD use and EHR storage include more efficient and accurate diagnoses, patient-centered care, meaningful chronic care management, and reductions in repetitious lab testing.
PGHD embedded in the EHR can also show providers patient wellness status between visits, illustrate patient health and behavior trends over a broad time period, improve patient medication safety, and inform patient-provider communication centered on shared decision-making.
The patient portal, a key part of the EHR technology suite, is essential for PGHD use because it allows patients to upload or modify their own data.
Despite the promise of patient-generated health data, its use is not widespread, the Playbook revealed. Forty percent of smartphone or tablet owners use their devices to track progress on health and wellness goals, and 30 percent use a wearable device such as a fitness tracker or glucose monitor.
However, only 20 percent of healthcare consumers already share their health information with their providers. Challenges to PGHD collection may include limited device interoperability or lack of expertise in clinician practices.
The push for more PGHD use begins with practice administrators, the Playbook suggested. Administrators should start by discussing with staff how PGHD can improve patient care and practice efficiency.
Next, organization leaders should evaluate what data they are already gathering and what data could be valuable. What provides insights about one patient population may not be relevant to another population, and organizations must be cognization of that.
Organization leaders should next create policies for gathering and reviewing PGHD. Although PGHD can offer valuable insights, it is not usable until an expert vets the information.
Finally, organizations must educate patients and family caregivers about the importance of PGHD to motivate them to continue sharing this data.
The Playbook authors recommended organizations start small and make it easy for patients to share their own health data. For example, a patient portal with multiple APIs that can plug into smartphone apps makes it easy for patients to share their medical information. This sophisticated technology is at the cutting edge of healthcare right now and can overhaul how patients interact with their own health data.
It may also be useful to increase efforts with PGHD that is understandable and usable for patients. All patients should share their medical histories, and this has been a common practice in medicine for years.
“Family health history can help predict a patient’s disease risk — essentially, it’s the simplest and least expensive form of genetic assessment,” the Playbook noted. “Traditionally, collecting and analyzing this information hasn’t been a routine part of primary care because of challenges like patients’ lack of knowledge about family history and providers’ limited time.”
Patients can now use technology to update and upload health histories. Patients with comment functions on their patient portal can amend or add different bits of information, streamlining the process and activating patients in their own care.
Organizations should use medical assistants to review family history before a visit as to not waste valuable time that could otherwise be dedicated to patient-provider communication.
Information about PGHD collection and use come as a new addition to the Patient Engagement Playbook, which ONC originally published in June 2016. The Playbook also reviews patient portal enrollment, selection of patient portal features, patient health literacy, third-party patient portal access, and patient education.