Category Archives: HIE

Welcome Home to Portland Maine.

I took a very long pause writing posts. Hey, it just happened. Life got busy. I moved. Both kids got planted in college life. And I’m firmly embedded back in New England.

I love Portlands. My first time living in Portland, Oregon was in ’79. It was way smaller then. Got a job in a research lab at the VA – #1 of several VA jobs. Then med school at OHSU, and primary care residency in Rhode Island. It didn’t take long to run back to the Northwest – with all the 365/24/7 green and those mountain glaciers. Learned to love rain. Came to Portland, Maine in ’97 – to combine research, practice improvement and medical education.

I soon met Richard Rockefeller, who introduced me to patient computing before most people owned a computer. He opened my eyes to possibilities of technology for health care and patient partnership. He was insightful, a pioneer with vision to see how the internet would create stronger partnerships between patients and health providers. I met him years ago when he began Health Commons Institute, a Maine non-profit that spread the word about patient-computer-provider opportunity. He participated in the seminal effort of Healthcare in a Land Called People Power: nothing about me without me. Richard introduced me to informatics, and was single-handedly responsible for shifting my career trajectory. I was fortunate to gain his support to study patient use of an early personal health record at Martin’s Point in Brunswick, Maine. Screen Shot 2014-08-27 at 3.04.29 AM The take home: people with chronic conditions used the portal as often or more often than the ‘worried well’ (those not with a chronic condition). That study was published in J. Medical Internet Research in 2004, “Using Claims Data to Examine Patients Using Practice-Based Internet Communication: Is There a Clinical Digital Divide?” These results were enough for me: I returned to Oregon for formal medical informatics education.

Now I’ve returned to Maine. The end of Portland-to-Portland transitions.

It was devastating to learn a few months ago about his tragic death. The world lost a wonderful creative soul and pioneer, passionate about improving peoples lives and connecting one another through the use of digital tools.
Richard, you are sorely missed, RIP.

The Society of Participatory’s Michael Millenson wrote a lovely blog post about Richard.

There’s great innovation happening here, and I look forward to jump into the fray. VA Maine and the VA Office of Rural Health recently embarked on connecting with the statewide health information exchange, HealthInfoNet. Maine’s HIE is a national leader, with aggregated data on the great majority of residents from all hospitals and most care sites. Using an opt out model, clinicians from across the state have real-time data at their fingertips. I look forward to helping with clinical adoption at Maine VA, and learn much more about shared health data that’s actionable for clinicians.

Next stop: HIE facing the consumer? Maybe not today. It’s still summer, the sun is shining and it’s a good day for a quick kayak in Casco Bay. Always nice to be on the water in Maine, but sad that there’s one less sweet soul with whom I planned to reconnect.

Patient portals, Blue Button & OpenNotes are the next generation of quality.

It’s been awhile since my last blog post. Summer does that. Particularly if there’s a winning combination of sun, beach, family, fresh corn (I heart Cape Cod). You get my drift. The right factors combine, giving you a great experience.

The same thing goes for digital tools. We intuitively know what’s needed. Easy login. Nice interface. Valuable functionality. Bringing the right information at your fingertips when you need it.

Making an application easy to use and beneficial doesn’t sound so hard, right? Yet why does it take so long for health care to figure this out?

I was asked to give a webinar on the topic of Patient Portals for Maine’s HealthInfoNet last week. I focused on the combination of features that bring the most value – in other words, what people need (based on what they use) and how positive change can happen – based on evidence and experience. We have a rapidly expanding literature about this information, and this data needs bright lights shining on it, firing it up.

I did a back of the envelope summary of some evidence. Not a systematic or exhaustive synthesis, but my cumulative view of a continuously expanding bibliography of relevant papers and presentations.

Co-presenters included Steve Bien, a physician at Wilson Stream Family Practice, the first independent practice to use Maine’s health information exchange. As an early adopter, Steve touted the use of secure email, remarking that online communication not only meets patient needs but reduces workload and offers efficiency. Nice to hear that from a small practice.

Adding the patient voice to the panel was Ann Sullivan, advocate and HealthInfoNet Board member. She provided insightful, day-to-day experience of how eHealth tools add value by fitting into the patient workflow (life!) through convenience, access and helping with self-care.

Thanks to Gemma Cannon, Service Coordinator for Maine’s Regional Extension Center, for convening the group to focus on patient meaningful use!

Slides from the @hinfonet webinar are available from HealthInfoNet and on slideshare.

Oregon Welcomes Regina Holliday to AIM Oregon HIE Conference, Part I

Today was a really great day. This morning I finished a draft of a whitepaper for the VA, about patient-facing health IT. Then I sped to the Oregon Convention Center, for Oregon’s 1st annual Health Information Exchange stakeholder conference.

AIM 2011 – Accelerate, Innovate, Motivate – was wonderfully attended, well organized and packed with great speakers from Maine, Vermont, Colorado, Tennessee and of course our own backyard. I was late so didn’t hear all that ONC Coordiantor Farzad Mostashari had to say (good they taped it). But the coolest thing was to see Regina Holliday, set up with easel and canvas, standing up front on a podium, to the right of Dr. Mostashari.

Regina is a force, a transformation, a sunburst embodied in a single body. Her important message has taken root. Just look at all the speaking engagements on her website, past and present. That message salience and poignance keeps growing – as health IT and information exchange and shared health data activities swirl and grow. Patient advocacy and participatory medicine are in the ring, and even though their volume could be turned up (way up), these things have a way of gaining traction.

Especially with stories and poems and paintings from @ReginaHolliday. She did 4 (four!) before the mid-afternoon speakers came on.

The first painting shows a large pink heart, and a woman’s face looking at the ONC Coordinator. Regina says its opening access to the personal information and it’s love, people getting information they want and need, to help lives. Nearby, a wireless tower offers the channel to make it happen.

At the conference, Carol Robinson, Director of the Health Information Technology Oversight Council, announced the Oregon e-Health Consumer Pledge and those who agreed to it. Regina painted Carol peering up at the dawn of the HIT revolution. Her outstreched hand has a caduceus medical symbol, with the bottom tip poked through her hand. The change will be glorious, Regina says, “but it will cause some pain.” The caduceus’ rod is the “i” in HIT, representing ‘Put the I in HIT’ campaign of the ONC.

Two more paintings followed. I can’t do their explanations justice, and will wait for Regina to talk about them on her blog.

All I can say is, thanks, Oregon HITOC, for bringing her stories and her art to the conference. Thanks, artiste Holliday, for your time and your heart(s) and your wisdom and grace.

Listen up, Health Information Exchanges: Let Patients Help!