The IxCenter published a white paper a few years ago entitled, “The Ix Evidence Base: Using Information Therapy to Cross the Quality Chasm” (available at http://www.ixcenter.org/publications/whitepapers.cfm). In it, we detailed the emprical evidence that supports the Ix role in addressing each of the 10 rules that Institute of Medicine (IOM) laid out for health care delivery system redesign.

As Ix has matured, we have found new ways that Ix has directly addressed the IOM/Quality Chasm call to action. Perhaps most importantly, the IOM’s first rule for system redesign was to have “Care based on continuous healing relationships.” Rather than just interacting with health care professionals in traditional visits specific to a particular acute issue, people should have mechanisms for ongoing contact wherever and whever they need it.

In this graphic, iom-rule-1-continuous-cycle-w-20.ppt, I offer one way to think about how Ix can advance continuous healing relationships. Specifically, Ix for visit preparation can be used to better prepare patient and clinician for an in-person clinical encounter. Since we know that 50% to 80% of everything a doctor tells a patient is completely forgotten by the time the patient gets home, the Ix after-visit summary is critically important for reinforcing the key pieces of information that transpired during the visit. Through PHRs and other patient-centered HIT tools, Ix can then be delivered for health promotion, risk reduction and ongoing care management to help maintain a continous cycle of care.

It raises some questions worthy of discussion…

Efficacy of the Model: Does you think this model works? Can it move us from episodic, disjointed encounters with the delivery system to continuous healing relationships?

Reimbursement and Infrastructure: Does an infrastructure exist to support this cycle of care? Does the current reimbursement system create too many perverse incentives to prevent this model from flourishing? Can the patient-centered medical home model (being advocated by the primary care medical societies and others) provide an effective mechanism for encouraging this kind of care delivery?

Fit with Health 2.0 Innovations: What do you think about the potential role of the various Health 2.0 activities (e.g., targeted search, content tagging, social networks, etc.) that I have laid on top of this model? Are there new tools that exist (or will soon) that will help to get us there more quickly than working through the traditional care delivery system?

I’ll be interested in your thoughts.

–Josh

We are eager to identify new strategies for helping practicing clinicians to make it easier to integrate information therapy (Ix) into their clinical workflow. One model that we have conceptualized is collaborating with leading local and regional quality leaders to stimulate Ix advancement in their own communities.

We are aware that this “Ix Across America” concept requires not only a combination of a lot of intense work and patience on our part, but also strong leadership from respected champions in each partnering community. I’m happy to report that our first test of this concept is off to a great start, thanks to the leadership of Helen Riehle, Executive Director of the Vermont Program for Quality in Health Care (VPQ), and several other committed innovators in the small but creative state of Vermont.

The report below summarizes the first phase of our “Ix Across America” best test in Vermont.

VPQ devoted its 2007 Spring Learning Forum to information therapy (Ix^®). VPQ has helped diverse medical practices across the state to implement learning collaboratives, particularly around Ed Wagner’s Chronic Care Model (CCM).

After some introductory comments from the VPQ Executive Director and Vermont’s Lt. Governor, I set the context by explaining Ix in detail and contextualizing it vis-à-vis the CCM and related quality improvement (QI) strategies. Ted Eytan, MD, MPH (family practice physician and Medical Director, Health Informatics, Group Health Cooperative), presented many specific Ix initiatives Group Health has implemented in the context of its broader patient-centered informatics strategy.
Rushika Fernandopulle, MD, MPP (Internist and Co-Founder, Renaissance Health), described how he has used Ix in a small practice. In both cases, these practicing physicians provided considerable detail regarding the challenges and solutions for integrating Ix into the clinical workflow.

Forum attendees separated for breakout sessions. Practicing clinicians, practice managers, hospital administrators, and others affiliated with specific clinical practices discussed opportunities for applying these Ix approaches to their own settings. Attendees representing state government agencies, quality organizations, and those representing Vermont Information Technology Leaders (VITL, the state’s regional health information organization or RHIO) engaged in a policy-oriented discussion of how the state could facilitate greater Ix adoption.

When the breakout groups reported back to the full audience after lunch, these robust discussions resulted in several concrete next steps for Ix advancement including: implementation of multiple specific Ix initiatives in different practices; incorporation of Ix and consumer-focused activities into VITL’s pilot projects; integration of Ix components into the Vermont Department of Health’s Blueprint for Health project; and other statewide collaboration opportunities. The most popular specific Ix initiative that
Vermont practices plan to implement is the after-visit summary, but clinicians and administrators plan to pursue several other initiatives as well and there is broad interest in personal health record implementation. With respect to VITL and the Blueprint for Health, leaders believe that the architecture that is created can be used to make Ix a more explicit goal. In addition, VITL’s first implementation project related to medication history could involve components that more directly support consumer engagement in their health.

In the afternoon, Bob Corrigan (Vice President, Product Management, Emmi Solutions) discussed the “power of conversation” and demonstrated an interactive, engaging approach to Ix via text, audio, video and other graphics. All of the day’s speakers and state health care leaders involved in VITL and the Blueprint for Health (Cy Jordan, MD, MPH, Medical Director, VPQ; Andrea Lott, CIO, Northeastern Vermont Regional Hospital; and Jeremiah Sable, MD, Public Health Physician, Health IT, Vermont Department of Health) participated in a panel discussion to identify the greatest opportunities for integrating Ix and consumer-facing HIT applications into Vermont’s critical statewide health care initiatives.

Both Ted and I were able to frame all the day’s discussions after spending the day before in individual practices in
Vermont and with leaders from VITL and VPQ. These visits provided context for the specific challenges unique to
Vermont clinicians and HIT leaders.

We look forward to following up with Vermont practices, hospitals, HIT leaders, and government agencies through several concrete next steps to ensure that HIT implementation involves consumer-focused initiatives. Other quality leaders who think their communities would be good Ix laboratories should let me know.

–Josh

Looking at how young people use the Web for virtually everything from commerce to social networking, it’s not hard to imagine an increasingly virtual future health care world. If Don Berwick is right that at least half of current in-person clinical encounters don’t require a visit, this generation likely will change the character of US health care delivery.

But what about the other end of the chronological spectrum? One of the common questions I get is how we make information therapy (Ix) relevant for seniors–the population that consumes the greatest amount of health care.

Although part of the answer is that Ix need not be delivered electronically, the more compelling notion from my perspective is that we have a magnificent and mostly untapped opportunity to extend patient-centered health information technology (HIT) applications to people who really need them.

The potential of the innovative applications that comprise patient-centered HIT (e.g., personal health records (PHRs), secure messaging, online tools, etc.) can be maximized if we successfully integrate them into patient-clinician relationships. Ideally, they should be viewed as tools within that context.

More than anybody else, seniors are likely to have ongoing and frequent relationships with their clinicians. In fact, in many cases, seniors concurrently interact with multiple providers, making the need for coordinated relationship management tools all the more important. Without them, we wind up with considerable redundancy, poor communication (not just between patient and doctor but among providers involved in that person’s care), and the possibility for dangerous medical errors.

Furthermore, other characteristics more common as people age (e.g., limited mobility, cognitive functioning issues) increase the importance of having patient-centered HIT applications. They can allow for communication without patient and clinician needing to be in the same place and for communication to be trianglulated–for example, to include the child or spouse of a senior with cognitive impairment.

Many seniors are already accessing considerable health care information online (to some, a surprising percentage), and there’s no doubt that the aging baby boomer population will vastly expand the online senior population in the near future. However, there’s no reason why we can’t do more to help more seniors capitalize on this golden opportunity now.

Community efforts involving librarians, hospital community outreach staff, senior centers, and others can effectively break down barriers limiting seniors’ adoption of e-health resources. Although I haven’t seen a lot of empirical data, anecdotal evidence suggests that, once obstacles are removed, seniors become active Internet users.

Who do you think the next generation of PHR users will be?

–Josh

(Visit www.ixcenter.org for more about PHRs and related issues.)

Congressman Patrick Kennedy (D-RI) re-introduced the “Personalized Health Information Act” at a Capitol Hill briefing today to incentivize adoption of personal health records (for details of the precursor PHR legislation from the last Congress, see my January 3 post: Patient-Centered Health Information Technology in the New Congress). Some of the observations about the issues that most struck me and their relevance to information therapy (Ix) about the two-hour briefing follow.

First, unlike the initial unveiling of the bill last Congress, Kennedy announced this version with a wide array of supporters. The briefing featured: a Republican co-sponsor, Dave Reichert (R-WA); provider and health plan sponsors from post-Katrina Louisiana (LSU Health Network, Louisiana Blue Cross Blue Shield); representatives of organized medicine (American Academy of Family Physicians); advocates from the voluntary health world (American Heart Association); and usual-suspect industry supporters (Microsoft, Medem, Allscripts).

Second, the message was clearer that this is less about health information technology (HIT) than about better care. Specifically, the congressman and his staff (Michael Zamore) drove home that PHRs are a vehicle to proactively delivering better, more personalized communication and care. It is interesting to note that, although it advocates vigorously for HIT, the specific mission of the House 21st Century Health Care Caucus (of which Kennedy is Co-Chair) is “to transform the health care system through information and technology to improve patient safety and health care quality, lower costs, and coordinate care.” Note that it specifically is not about IT but “information AND technology.”

Third, and somewhat related, Kennedy (and others) made the point that even though “people aren’t clamoring for ‘health IT,’” those dealing with the challenging health care issues want the functionality of PHRs whether they call it that or not. The congressman noted that people with chronic conditions know how difficult it is to get the health care information they need and they are increasingly expressing that need in various ways. Or, as Medem CEO Ed Fotsch analogized, “I don’t care about the bank’s information technology systems, but I want the ATM to work.” He suggested that this legislation can help to harness the consumer as a market driving force, similar to what happened in the banking industry with ATMs.

Fourth, the focus on advancing proactive delivery of personalized communication to improve care was shared by all of the legislation’s sponsors. Most interesting to me was that Microsoft specifically was focused on information therapy (even if MS Corporate VP Peter Neupert did not use that terminology or “Ix”). In focusing on the fact that health care is essentially an “information management issue,” Neupert’s language literally paraphrases the informal Ix definition. He described health care being “about getting the right information to the right person at the right time and making sure that information is accurate.”

Neupert also said that “the data is a necessary but insufficient condition…for making the right decision,” much the point of the Issue Brief I authored for the California HealthCare Foundation, “Lost in Translation: Consumer Health Information in an Interoperable World ” (http://www.chcf.org/topics/view.cfm?itemID=114624). Or, perhaps more to the point, in the Q&A, he also agreed with my amendment that the “right information” must not just be accurate but also be meaningful and understable to the average consumer. In fact, several of the panelists were sufficiently interested in this issue to respond to the question. People recognized that this important legislation represents an important beginning in the government’s effort to advance personalized communication and strengthen patient-clinician relationships.

It’s clear that the raw data populating PHRs (often deriving from administrative and clinical data sources) have little intrinsic meaning to the average consumer without some mechanism for translating that data to practical and usable information. We need to develop a blueprint for patient-centered HIT that provides infrastructure for PHR adoption and the practical use of such tools by a diverse range of people with varying needs and backgrounds.

The IxCenter is embarking on such a project and you can get a taste of it from some of the work we’ve been featuring on PHRs and related topics (see our Web site at www.ixcenter.org). By the time of our annual Ix conference (October 8-10 in Park City), we anticipate this work being in full swing, so make plans to join us there. In the interim, interested parties should contact me (jseidman@ixcenter.org) to find out if their work has synergies with ours.

–Josh

Following up on Tuesday’s posting, another question that came up a few times in our webcast, “MyHealth, Circa 2007: Consumer Needs and Market Responses in eHealth,” related to consumer privacy concerns.

I believe three things about privacy and security related to online personal health information (PHI).

1. Every provider, system, Web site or other entity that collects consumers’ PHI must invest time and resources to protect PHI and make a firm commitment to ensuring its privacy and security.
2. It can be done effectively–if done right, these electronic entitites should be able to protect PHI better than more traditional mechanisms for storing PHI. Many successful examples already exist in health care, but we can see even more examples in other industries. After all, it wasn’t long ago that experts said that people would never transmit credit card information online in order to buy books–yet Amazon seems to have a few customers.
3. Ultimately, what will make the difference for consumers is the value of the online tools. Most people who use online banking and shopping cannot imagine ever going back to the old way of doing business even though there always exists some risk for identity theft, etc. If online health tools provide consumers with clear, understandable, useful information that meets their particular needs, they will be willing to assume the minimal risk associated with online tools that make a strong commitment to protecting their PHI.

Let me be clear: I absolutely believe that consumers’ privacy and security concerns are real and critically important issues. We should and can address them fully.

–Josh

We held a public webcast on this topic today. Susannah Fox, Associate Director of the Pew Internet Project, not only shared valuable insights but also some of Pew’s as-yet-unpublished data. The presentations and the audio recording from both of our presentations will be available on our Web site in the near future.

We had nearly 100 unique logons to the webcast and more than 25 questions, so we didn’t have time to answer all of them. Over the next few days, I’ll try to answer questions we didn’t get to and elaborate on a few that I have been thinking about for various reasons. Also, Susannah Fox will post comments on this blog (as time allows) as well…although I’m sure that you’ll need to tune in to her upcoming Pew reports (available at www.pewinternet.org) to get all her insightful thoughts.

Q: Why can’t we have a way for doctors to upload my personal health records to a private page on a social network site that I can then share with other providers or people in my community?

JJS thoughts: This is a great idea, and clearly an activity that would support a much more collaborative care environment that would help improve (to paraphrase Dartmouth’s John Wasson) “same-page care” (getting clinicians and their patients on the same page). Unfortunately, there has been little progress in this arena outside of some integrated delivery systems (perhaps Group Health Cooperative in Seattle being the most advanced example). Some of the organizations that Wasson works with through a couple of innovative initiatives (see www.howsyourhealth.org and www.idealmicropractice.org) are getting at this in different ways as well.

No doubt part of the reason is that an infrastructure doesn’t exist to support it, and we’re working on two aspects of that infrastructure. First, we need to address the consumer-facing side of IT interoperability so that we can effectively connect consumers to health content that they can make sense of. I wrote an Issue Brief for the California Health Care Foundation about this issue (see “Lost in Translation: Consumer Health Information in an Interoperable World” at http://www.chcf.org/topics/view.cfm?itemID=114624).

The second infrastructure piece that we are trying to address is the payer side of the equation by creating technical specifications to define what constitutes Ix. The goal of our Ix Payer Workgroup is to provide guidance to pay-for-performance, provider recognition, and other programs so that they can recognize when providers, organizations, or tools provide people with information that supports their information needs with respect to decision support, behavior change, or other health needs.

I’ll address other questions tomorrow and in the days ahead.

–Josh

I attended a fascinating Health Affairs (www.healthaffairs.org) briefing on “A Rapid-Learning Health System” this past Friday, January 26 here in Washington. The project was led by Lynn Etheridge and Health Affairs and sponsored by the Robert Wood Johnson Foundation (www.rwjf.org), Kaiser Permanente (www.kp.org), and the US Agency for Healthcare Research & Quality (www.ahrq.gov).

Your first question may very well be, “What the heck is ‘rapid learning’?” The vast real-world databases created by electronic health records (EHRs) maintained by integrated delivery systems such as Kaiser and the Veterans Health Administration (VHA) create a phenomenal research capacity. With literally tens of millions of longitudinal, clinical member/patient records, the combined power to understand the effect of all kinds of care practices is staggering.

As Kaiser’s Paul Wallace (also the IxCenter Board Chair) pointed out, the number of newly diagnosed cancer patients in Kaiser’s EHR each year (about 40,000) is roughly the same as the number of patients enrolled in US cancer clinical trials. As Geisinger’s Buzz Stewart wrote in the Health Affairs Web exclusive, there is a clinical trials also deal with “clean” populations (often excluding the “messy” patients with multiple co-morbidities). EHR databases can help to bridge this “inferential gap” to help us figure out what to do about those people with conditions for which the traditional scientific process doesn’t provide a good answer.

Perhaps even more important than the contribution that this database can make to helping to heal people with new cancers is the impact it could have on the woefully understudied issue of cancer survivorship (understanding the health impact of “cured” cancer on survivors years or decades later). When the clinical trial is over, researchers often stop collecting data on their “subjects,” but Kaiser has a quarter of a million longitudinal EHRs on cancer survivors. That could have a great impact on our ability to address unexplained health issues that arise from the intense therapies to which people with cancer are subjected.

But answering these kinds of questions are just the tip of the iceberg. As Archimedes (www.archimedesmodel.com) Co-Founder and Chief Medical Officer David Eddy (also one of the pioneers in evidence-based medicine) noted, while tremendously valuable, applying the “look up” method to EHR databases tells you a lot about the past and the present, but it can only tell you so much about the future if nothing new happens. This is where the miracle of modern mathematical modeling comes in.

Now I’m not going to embarrass myself by trying to explain how models like Archimedes’ work, but there are a few critical points to understand. First, there are powerful representational modeling techniques now used in every industry from entertainment to transportation to architecture, and there’s no reason why—with adequate investment and data sharing—we can’t do the same in health care. Second, these models employ techniques to integrate data from much more discrete components (such as the progression of disease on the physiological level). Third, because of that, these models have a tremendous capacity to assess virtually everything that can happen (depending on the data that we have). Just to give you an idea of the potential power, Eddy and colleagues have prospectively predicted the outcome of many clinical trials (not that he’s saying that we should just get rid of RCTs)—for an example, see Exhibits 1 and 2 in the Health Affairs January 2007 Web exclusive by David Eddy.

With EHRs, there suddenly is a vast expanse of new data that can be integrated into models like Archimedes. The combination of EHRs and sophisticated representational modeling techniques can, to paraphrase Eddy, “put rapid learning on turbo.”

As amazing as these models are at this point, they still may not help us address some of the major quality-of-care gaps in the US if they rely only on the clinical and physiological data that currently power them. We know that one of the critical reasons for poor performance on quality measures is our inability to inspire healthful behaviors. For example, we know that a substantial portion of mortality and morbidity in the US are due to three behaviors: smoking, poor diet, and lack of adequate exercise.

Luckily, the science of behavior change is evolving, and with it our ability to understand how to effect positive behavior change. What if we integrate the models developed by people like David Eddy with the behavior change science developed by people like Jim & Jan Prochaska? (In case this is new to you: The Prochaskas have not only done pioneering work on the transtheoretical model but have developed a series of science-based tools for effecting behavior change.)

At the briefing, I asked Eddy if this was possible. He remarked that, as long as we can measure it, we can integrate virtually anything into these mathematical models. Indeed, new measures of behavior change and patient activation have been developed by people like the Prochaskas and Judy Hibbard. Others, including those in government health programs, are beginning to explore that measurement arena as well.

The opportunity not only for rapid learning, but for truly transforming care is enormous. We need to push the envelope on the scope of our inputs to EHR databases. At places like Kaiser, Group Health Cooperative, Geisinger and the VHA, they already have the opportunity to tap into rich sources of patient-reported data (such as health risk assessments, secure messaging, and other online applications where consumers enter in personal health information—all of which, of course, needs to be protected as with any other human subjects research). Let’s find ways to move this agenda forward.

–Josh

With Revolution Health launching its new consumer portal, a newspaper reporter called me earlier this week to ask what I thought about new efforts such as this….

It’s clear to me that—even though they generally don’t express it this way—consumers are clamoring for information therapy (Ix). And just to be clear, Ix is not simply a shorthand for health information. Ix involves delivering information targeted to a person’s specific moment in care and tailored to the individual’s particular needs.

A wide variety of consumer research makes it clear that consumers are hungry for health information. For example, Susannah Fox from the Pew Internet & American Life Project (www.pewinternet.org) has previously described a “Dr. Google phenomenon” in that, in a typical day, more people go online to get health information than visit doctors to get answers to their health questions.

I fully support the democratization of information ushered in by the Internet and other forces, but I also realize that it’s not fulfilling the needs of many consumers. Most consumers aren’t interested in generic health information. They want answers to specific questions at a particular moment in care that relate to people in their specific circumstances.

To date, the Internet hasn’t delivered that. It’s akin to having a garden with plants, flowers and vegetables that need varying amounts of water and the weather gods delivering a monsoon.

Part of the reason that the term “information therapy” has value is because of the corollaries between it and medication therapy. Information overload can result in an “overdose.” Consumers reading the wrong information can experience negative “side effects.” The right kind and amount of information depends on the specific individual, which means that we often need to “titrate the dosage,” much the same way doctors might adjust the dose of warfarin (Coumadin) for patients with atrial fibrillation (an irregular heartbeat).

Going online for health information generally involves (at least) four challenges. First, can you find the information you need? Again, it’s not hard to find information, but it’s another thing to find it highly specific to your need at a particular time. Once you find it, do you understand it? Has it been provided to you in a way that you can make sense of it? Third, there’s the issue of whether you can remember it.

Finally, even if you can find, understand and remember the information you need, you still may need help in contextualizing it for your own situation. That’s why there often is value in having your personal health library as part of bidirectional communication system with your clinician (of multidirectional to the extent that it involves multiple care professionals). With all that in place, then you’re ready to act on the information to improve your health, decision making and healthy behaviors.

The answer I had to give to the reporter is “I don’t know.” It’s far too early to tell whether Revolution or Google Health will create the kind of navigational support that will guide consumers to the Ix they need. At the very least, however, the fact that people with the resources of Steve Case and Google are pouring money into finding answers tells us that there’s a lot of interest in figuring this out.

There’s no doubt that much research remains to better understand what the optimal dose, frequency, and duration of information prescribing is for people in different circumstances. We are beginning to pursue this as part of our Ix research agenda and, when we figure it out, we’ll be sure to let you know.

–Josh

The Center for Information Therapy (IxCenter) holds periodic public webinars in addition to our monthly IxInsights webinars for IxAction Alliance members. Typically, we get 20-40 participants for these sessions. Yesterday, we sent out a notice about a webinar we’re holding on January 23 on “Personal Health Records (PHRs) and Information Therapy: Transforming Health Care.” Less than 24 hours later, more than 100 people have signed up.

I’m certainly not the first person to suggest that PHRs have the potential to be a major disruptive force in health care, but there are many reasons to believe that the hype behind this “next thing” actually has some legs. Although the focus of many health information technology (HIT) advocates over the last few years has been on the provider or system-oriented electronic health record (EHR), it’s the PHR that actually has the potential to dramatically change the organization of health care delivery.

Direct access to, and control over, one’s personal health information (PHI) could be another catalyst in the democratization of health care, similar to the way that the Internet has democratized information flow (regarding health and everything else).

However, also like the Internet, the PHR’s potential may be limited in health care if we don’t find ways to make PHI more than a series of data points swirling around some consumer portal. The PHI must be conveyed so that it is understandable, usable and meaningful to the average consumer. If it exists in a vacuum, it will have limited utility.

One of the critical aspects of information therapy (Ix) is figuring out how to contextualize the PHI by connecting it to content. Moreover, those who have a stake in consumers using PHRs to better manage their health need to think about how to deliver proactive streams of information targeted to consumers’ specific moments in care and tailored to their individual needs. This dual functionality–contextualization and bidirectional communication–is critical to enabling PHRs to fulfill their promise.

It would be valuable for the audience of this blog to hear some stories from consumers and clinicians about how this has played out.

–Josh

With the 110th Congress about to get underway, it’s exciting to think about the possibilities for patient-centered health information technology (HIT) legislation. Last fall, Congressman Patrick Kennedy introduced a bill (HR 6289) that would create incentives for using personal health records (PHRs). Unlike much of the HIT legislation out there, it really focuses on consumer’s personalized information needs and enhancing the clinician-patient relationship. In particular, the bill describes requirements including that a qualifying PHR has the capability of “sending patient-specific patient education, reminders, and clinical messages to patients based upon data in the record.”

The bill, appropriately titled the Personalized Health Information Act, that was introduced in the 109th Congress likely will be reintroduced soon for the new Congress. Although it’s not clear how strong the financial incentives will be (though private & public organizations can contribute to the incentive fund with targeted information therapy (Ix) campaigns), there are several sections that are all about Ix…without calling it that. For example,

• One of the provider requirements is that (Sec. 2.c.4) “The physician (or provider) uses the QPHR as appropriate and authorized by the patient to communicate appropriate patient education and care management messages.”
• And the entire section (2.e.1.E) on “Messaging Capabilities” is all about Ix…

E) MESSAGING CAPABILITIES-
(i) EDUCATION REMINDERS- Subject to clause (v), the record is capable of sending patient-specific patient education, reminders, and clinical messages to patients based upon data in the record, but such messages shall not be sent unless such messages comply with standards adopted under paragraph (3). The Secretary shall work with the Secretary of Homeland Security and the Director of the Centers for Disease Control and Prevention to optimize the public health and emergency response capabilities of the networks created by QPHRs.
(ii) FEDERAL REMINDERS- Subject to clause (v), the record provides for the sending on behalf of Federal agencies of objective, accurate, patient-specific messages to patients concerning their health care or benefits, but such messages shall not be sent unless the messages comply with standards adopted under paragraph (3).
(iii) FUND PARTNER MESSAGES- Subject to clause (v), the record provides for the sending, on behalf of Fund partners who contribute to the Fund, appropriate patient-specific messages to consumers (with whom such partners have pre-existing relationships) concerning the patients’ health care, medications, treatments, medical devices or benefits, but such messages shall not be sent unless such messages comply with standards adopted under paragraph (3).
(iv) HEALTH PLAN NOTIFICATION- The QPHR service notifies, no less frequently than quarterly, each Fund partner that administers a health benefit plan of the individuals who are enrolled in the plan and who have a QPHR established.
(v) LIMITATION ON COMMERCIAL SOLICITATION- The record does not allow any commercial solicitations, marketing, or messages to patients unless the patient is a patient or beneficiary of the sender, uses the sender’s product with a prescription or recommendation of a provider, or has some other pre-existing relationship (as defined by the Secretary), or other messages that do not comply with standards adopted under paragraph (3), and the record ensures that every message clearly identifies the source of the content.
(vi) PATIENT OPT-OUT- The record allow a patient (or patient’s authorized representative) to opt out of receiving messages entirely or from particular sources.Honestly, I don’t have any idea what the chances are for this legislation to move forward, but at least it’s nice to know that HIT legislation is being proposed to address the ways that HIT can truly support patient and consumer empowerment.

Honestly, I don’t have any idea what the chances are for this legislation to move forward, but at least it’s nice to know that HIT legislation is being proposed to address the ways that HIT can truly support patient and consumer empowerment.

Let’s hope that this is just the beginning.

- Josh