HealthAlbum

Imagine an Internet-based system where a parent, caregiver, or community health advocate could have secure access to a health dashboard with the health status of an entire family, minor children as well as elderly parents. This "health dashboard" would present the user with:

• Summaries from all published research worldwide on specific diseases that afflict a family member
• Centralized storage of all medical records for the entire family (“Family PHR”) where all physicians that have ever attended to any family member are expected to deposit all relevant information about each family member (this data belongs to the individual or legally responsible adult)
• Access to the latest Evidence-Based Medicine ("EBM") guidelines, as published by respected agencies (such as the US, Canadian and British governments), that are relevant to each of the family members. That is, the dashboard user will be able to review the latest EBM guideline for each disease prior to a visit to a physician, to ensure that the family member receives the best possible treatment
• The health information is available to the user via a mobile phone; PDA; office PC; home computer
• Help the family to manage the enormous amount of paperwork and bills generated when an individual goes through a healthcare system with multiple providers.

This concept was outlined in Jose C. Lacal's presentation about Health Relationship Management ("HRM"), December, 2005.

Consumer-Owned Health Relationship Management ("HRM").

The HRM concept is an extension of the traditional Customer Relationship Management (CRM) systems already widely deployed in industry: HRM is designed to leverage CRM’s capabilities to develop a health equivalent, Health Relationship Management (HRM) systems.

Do you know anybody with asthma, cancer, cystic fibrosis, diabetes, or any other serious illness? Are you aware of the large amount of paperwork, records, appointments, co-pays, deductibles, and other data management issues generated by their illness? The HealthAlbum software can help consumers to manage all the family's health data in a centralized repository.

Business software labeled Customer Relationship Management ("CRM") is used by institutions to manage all the relationships with their users and customers. The goal of a CRM system is to increase the institution’s effectiveness and profitability.

OpenPHI's HealthAlbum software turns CRM on its head: the HealthAlbum software gives a Consumer and her family the tools to manage all their relationships with healthcare providers the family interacts with. With the end goal of improving the family's health. We call it "Health Relationship Management" ("HRM") as opposed to CRM

The table below summarizes how HealthAlbum leverages the well-established framework of CRM:

Action	CRM	HealthAlbum
Relationships to manage?	With prospects and customers	With healthcare providers
Files to store	Proposals, quotations	Family members' health records
Coordinate	Business calls, meeting calendar	Appointments, family calendar
What to track?	Product bugs, defects	Illnesses and treatment plans
Compile	Knowledge set	Relevant healthcare literature
Archive	E-mails, faxes	E-mails, faxes
Analyze	Sales trends	Health trends
Access Control Lists (ACLs)	Role-based access (Role-based ACLs mean that Consumer has the ability to select who gets to see the data stored in the HealthAlbum)	Multi-user

CRM provides businesses with a "Business Health Dashboard" to monitor the financial condition of the organization. OpenPHI's HealthAlbum software provides Consumers with a "Family Health Dashboard" to monitor and improve the health of each family member. The Consumer will also be able to store all her family's health information on her local computer using industry standard formats and templates. This will be an enhanced Personal Health Record ("PHR") system.

This is how the HealthAlbum software looks like:

Click image to maximize it.

A Consumer-Owned Health Data Ecosystem.

This is where HealthAlbum fits into a consumer-owned health data ecosystem

Click image to maximize it.

These are the use cases indicated in the diagram above:

1. Consumer has surgery at Hospital A. As part of Hospital A's process, a record of Consumer's stay at the facility is created and filed (either electronically or on paper). Consumer requests a copy of such record for her own use.
2. The data from Hospital A is uploaded into the Consumer's HealthAlbum software at home.
3. Potentially, and with the Consumer's prior approval, updated information from the HealthAlbum can be sent back to Hospital A to be added to Hospital A's record of Consumer.
4. Consumer will select, out of all the data stored in her HealthAlbum, a relevant subset for sharing with Provider B. Consumer has the indisputable right to mask / hide portions of her health data. But Consumer has no right to change any such data.
5. Provider B needs to be assured that whatever information Consumer provided is accurate and traceable to a trustworthy source. The concept of ePedigree is applicable here.
6. Staff at Provider B will generate additional data during the encounter with Consumer.
7. Provider B will generate a new clinical record that includes the data provided by the Consumer in addition to the data generated by Provider B.
8. The data from Provider B is transferred to the HealthAlbum.
9. In case of emergency, Consumer will provide a selected subset of her health data to Hospital C during the course of an emergency procedure. Consumer may choose to "mask" portions of her complete HealthAlbum depending on the context of the treatment.
10. How comfortable will a provider be (legally, ethically) to make a life-or-death treatment decision based on health data provided by the Consumer? Conversely, what are the legal implications if the provider does not take such Consumer-provided data into account and a bad outcome occurs?
11. Consumer will be given a copy of the health data generated during his stay at Hospital C.
12. The data from Hospital C is transferred to the HealthAlbum

How HealthAlbum Works.

We use proven technology called "computer virtualization" to allow Consumers to run an entire web-based server in their home PCs.HealthAlbum is available as a self-contained Virtual Machine ("VM"). It does not modify the Consumer's PC.

Some uses for HealthAlbum:

• compile and organize a family's health data in a single place
• with complete privacy and security (data stored in Consumer's own PC)
• control who sees the family's data
• share data digitally, if so chosen
• access verified health databases

Technical Details.

HealthAlbum is built on secure and reliable Free and Open Source Software ("F/OSS"). See Open Code for a list of the software packages we currently use and offer services on.

The diagram below explains the technical characteristics of the HealthAlbum software:

Click image to maximize it.

Will Consumers Manage Their Health Records?

Yes. Many are being forced to because:

• Consumers are now responsible for their own health, and their healthcare costs. But given little assistance to improve their health.
• Provider-based Health Information Technology ("HIT") will take a long time to become widely deployed due to lingering political, economic, operational, competitive challenges.
• Increasing numbers of Consumers have chronic, life-long diseases that need long-term management, care collaboration, coordination. Against an episode-based healthcare system.
• At OpenPHI, health management is an engineering challenge, and we are bringing engineering insight and processes from other scientific disciplines to the health domain.

Consumers already handle their financial, business, and personal life digitally. Why not their health data? OpenPHI's software complements Consumer's technology arsenal:

• Millions of broadband-enabled homes with PCs, printers, scanners.
• Many American homes have more IT and telecom tools in place than the majority of physicians's offices do.