Dr. Wendy Graham, a North Bay physician, is spearheading the introduction of a personal health record (PHR) application that promises to revolutionize the practice of medicine in Canada.
Called MiHealth, the web-based application offers patients access to a summary of personal health information that they can share with multiple health-care providers and family members.
It also features secure messaging functionality that allows physicians to share lab results with patients and notify them when it's time for a pap test or mammogram.
"We have a silver tsunami coming at us that is going to cripple the health-care system unless we empower people" to actively participate in their own health care, said Graham. "We just have to do something different, and we have to do it now - not in five years."
The MiHealth PHR contains the individual's family history, main diagnoses, medications, allergies, immunization records, physician contact information, appointments and insurance providers. The PHR is accessible from any Smartphone, including Blackberries and iPhones, or from any computer with Internet connectivity.
Graham, a member of North Bay's Blue Sky Family Health Team, was introduced to the technology at a conference in Washington, where she met representatives from Diversinet, a Toronto-based software company specializing in secure mobile applications for the health-care sector. The conference featured a presentation about a U.S. military application using Diversinet software that links "wounded warriors" with their case managers and other military personnel.
The application was adapted for a family practice environment and piloted by 100 patients at the Blue Sky Family Health Team from December 2009 to June 2010.
MiHealth's messaging functionality will help physicians practice preventative health care by reminding patients to have their cholesterol checked or to have a fecal occult blood test.
"I have 1,900 patients and 600 over the age of 50 who I contact for preventative health issues," said Graham. "Even if 40 per cent of these people want to do it online, it's much better organized and much more certain that they're receiving the information than if I was mailing letters and calling them."
The application is also useful in emergency situations. A patient showing up at an Emergency Room can fax his MiHealth PHR data to a hospital fax machine from his smartphone or provide an ER physician with a password to access his health record from any web browser.
The patient can share a subset of the PHR with specialists, nurses, dietitians and other allied health professionals, as well as with family members.
"You can share none of it, a little of it, or all of it," said Graham. "The patient is in the driver's seat."
MiHealth stands out from other commercially available personal health record applications such as Microsoft's HealthVault or Google Health by being doctor-endorsed - that is the patient and the family physician are supposed to enter the data together.
An Electronic Medical Record application is great for storing a patient's health information and test results in a physician's office, but doesn't provide access to patients and other health care providers.
"In our practice, we have 15 physicians," said Graham. "Seven of us are using EMRs, but we have three different systems. If you all have the same one, you can access Ontario MD funding, but once a physician installs an EMR, they rarely switch. It's just too painful."
Graham regularly finds herself toggling between multiple systems - her own EMR, the hospital's Meditech system, PACS diagnostic images and PACS reports. "It's in and out, in and out, in and out. There's nothing that ties them all together."
The health-care system is plagued by too many systems and information overload, "and I don't think it's going to get any better," said Graham.
Adding to the complexity is the amount of information that still arrives in physician offices off the fax machine.
"I can't cope with the information overload in my office," said Graham. "I have at least two and a half inches of paper coming through every day. Some of the results are automatically populated in my EMR, but there's still a lot of paper.
I've given up trying to scan it all. I'd have to hire two people to do it.
Graham spends an hour a day going through reports and has her staff use MiHealth to communicate the results to patients at the end of the day.
MiHealth is a big time saver for both patients and physicians, said Graham.
"Patients don't want to come back to find out that their test is normal and they don't want to spend three days getting busy signals trying to telephone me."
Graham said she knew MiHealth would be a success from the response of an illiterate patient with diabetes, cancer and a chronic pain from a fractured back.
"When I explained to him that he could have the information entered for him and it could be available for any of his appointments, he said, ‘Sign me up.'"
He religiously checks his blood pressure and sugars at home and saw MiHealth as a way to show his doctors that he's a good patient, said Graham.
With Bluetooth enabled blood pressure cuffs and glucometers, she added, the actual readings could automatically populate MiHealth, precluding the fudging of numbers by patients who "want to look good."
In another case cited by Graham, a man who was given access to his mother's MiHealth PHR learned that she had a benign calcified meningioma. " He said, ‘You mean it's not a tumour I have to worry about? My mother never told me that. You have no idea how happy I am that I know what it is.'"
Graham has a greater appreciation for electronic health records than most physicians, having lost everything in a fire several years ago.
"The firemen came and banged on the door before lunch and said, ‘Your building's on fire. Please get out.' We took our clothes, our shoes and our appointment book, went down to the parking lot and watched the building burn down. We lost everything in 20 minutes. I went back to work with a stethoscope, a prescription pad and no patient records. It was awful."
A proponent of sharing records with patients, Graham was pleasantly surprised when patients started bringing back copies of their records.
"Prior to the fire, I photocopied patient records all the time," she said. "I believed that the Supreme Court of Canada was right that it was patient information and it belonged in their hands."
MiHealth is scheduled to launch a commercial pilot this summer. Graham said she is optimistic that it will be available to the general public "soon" and hopes to market it for no more than the cost of two cups of coffee a month.
www.mihealthglobal.com
