(PHR) based on international open standards - ICMCC


(PHR) based on international open standards - ICMCC

Facilitating patient empowerment

through an online

personal health care record

(ong>PHRong>) ong>basedong> on international

open standards

ICMCC 2007

Where are we today?

We’ve entered an era in which the

awareness that the way we organize

healthcare has to change dramatically, has

reached critical mass

What is the goal for the near future

To adapt our healthcare system in such a

manner that we can provide the same

quality healthcare at affordable costs

beyond 2015

How could we accomplish that?

Option 1.

Solve problems as they arise and improve

existing systems according to the needs of

the current users and stakeholders.

100 years ago faster transportation method

was required for numerous reasons

Horse carriage

Horseless carriage

The horseless carriage evolved to a car

Now the following ‘issue’ came up

So new roads were constructed and things

went fine. Untill .......

So more and broader roads were created

And better, faster and intelligent cars were


This has lead to a near perfect machine.

But there’s still one ‘tiny’ problem....

A traffic infarct is inevitable. The roads are clogged so much

that a relative small incident will block all traffic in critical areas

As a result

It will take more time to get to a hospital, in

case of an emergency, than 100 years ago

Incremental innovation

This kind of approach is called incremental innovation

and works fine if:

- there is sufficient time to create alternative solutions

- it concerns non critical processes (improvement of

washing powder)

- there’s no clear vision of what will happen in the

near future

How could we accomplish that?

Option 2.

- create a clear vision of challenges and

opportunities in the (near) future

- design and create a solution ong>basedong> on this vision

- Make it as flexible as possible and use, if present

and suitable, international ‘openstandards

This strategy could lead to a complete new

approach to ‘bypass’ the traffic infarct

Radical innovation

The strategy where you start from the endpoint/

envisioned future is called radical innovation

- this can quickly lead to complete new products/

services (PIN/ cash teller, e-mail, virtual stores)

- the risk is that the ‘gap’ is too big and/or that novel

technologies don’t ‘land’

- current stakeholders are not always your biggest


So how to deal with the

healthcare infarct that’s

threatening our society?

Our analyses (and this is largely shared by

our governments) is that:

- a healthcare infarct will occur 8-15 years from now

- we’re still in the phase of incremental innovation

- already there are many good approaches in the

right direction, but still something is missing

- we should add a new ‘dimension’ (the highway in

the sky) that can ‘catalyze’ radical innovation in

order to ‘bypass’ the upcoming infarct

First an overview of some new approaches

Robots that will take over more and more


For example in activing elderly people

or in washing elderly people

Agents will automate and/or support more

and more healthcare processes

- telemonitoring: automated assesement of health

status (Health buddy)

- decision (support) systems: automated assessment

of self-limiting diseases (digital consult)

- preventive screening/ risk assessment ong>basedong> on

personal profiles (GezondheidsKompas)

- compliance assistance tools

- treatment of psychological disorders

- ...

Serious gaming will find it’s place in

stimulating/ activating/ connecting people

So what is this extra dimension to be added

for a ‘future proof’ healthcare system?

- that the patient/ client (citizen) will be given control

over his own medical data thus the control over his

own health and healthcare

- this will not only facilitate true patient empowerment

but also catalyze radical innovative processes

- this dimension is represented in the citizen

centered personal health record

What are the requirements for such a ong>PHRong>?

- citizen centered. The healthcare of the citizen is leading in

every aspect. Citizen controls who, what and when

- autonomy of health professionals is guaranteed and

maximally supported

- healthcare professionals will have full control over their medical

domain (use the archetypes generated by the professionals)

- international open standards are used to provide state of the art


- data stored in ong>PHRong> must be of such quality the machine

interpretation is possible while responsibilities remain clear

What needs to be done to meet those

requirements in the near(est) future

- luckely most requirements can be techically met

today, thanks to the hard work of a group of


The GEHR/ openEHR community

- since their vision is largely embedded in a open

international standard (CEN/ISO 13606), even the

required standards are already there

How could such an ong>PHRong> look like (mind the


Self-measured data is acquired in such a

manner that it can be used by HCP


Druk in




. .


G. . .


G. .












1/3/06 23/11/06 14/4/07

External ‘authority's guarantee quality and

compliance to standards


- EuroRec

- others

Citizens should also be in control of

security and privacy


St. PGD.nl


Board of the foundation should be formed by

citizens representatives (f.i. NPCF, Ambo, ....)

Foundation controls access and future




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