Quality Health care…there’s an App for that! Published April 3, 2012 By Lt. Col. Douglas A. Gimlich 97 Medical Support Squadron ALTUS AIR FORCE BASE, Okla. -- The growing cost of American health care has been the subject of much debate lately, both in the civilian market and in the DoD. Since 20 cents of every GDP dollar represents health care spending, experts and leaders alike recognize the responsibility and challenge that comes with reform. Even among the DoD, it is common knowledge that we spent less than $20 billion for military health care 10 years ago and last year we spent $50 billion. So how do experts recommend that we curb this spending? One way is through Information Technology. However, we are not talking about the bleeding edge; we are talking about proven technology that is on its way to Altus in the coming months. One of the solutions to health care inflation that most parties can agree upon is to increase patient ownership of their health care. The key to this ownership is the Personal Health Record (PHR), which acts as a medium between patient and provider. So what is a PHR? According to Wikipedia, "a PHR is a health record where health information related to the care of a patient is entered by the patient. The intention of a PHR is to provide a complete and accurate summary of an individual's medical history which is accessible on-line." As PHRs have evolved, the concept of a patient portal has gained acceptance and is typically defined as a view into the electronic medical record. In addition, ancillary functions that support a health care provider's interaction with a patient are also found in those systems. Examples include prescription refill requests, appointment requests, electronic case management, messaging and more. So what do PHRs have to do with Altus? Many customers of the 97 MDG don't know that they have had access to a PHR for years. The PHR we are talking about is TRICARE on-line, or TOL, as it's commonly known. What started out as an information resource and means of booking appointments on-line has grown into a world-class patient portal. TOL is the only DoD portal that provides a single point-of-entry to a suite of features supporting patient participation in their health care experience. TOL offers applications such as on-line appointment management and prescription refill requests and provides patients with read-only access to basic personal health information from their electronic health record. A new feature, the Blue Button, allows users to access expanded personal health data including lab results, patient history, diagnoses and provider visits. These features are an expansion of the current capability allowing beneficiaries to safely and securely print their demographic information, allergy and medication profiles. Perhaps the most anticipated Blue Button feature is secure messaging, also known as MiCare. Scheduled to be available to Altus in late summer, this feature provides a secure, Health Insurance Portability and Accountability Act of 1996-compliant, method of exchanging e-mail with your health care team. With MiCare, patients can easily request and provide information at any time providing a secure patient portal ensuring easy and private on-line communications in order to connect beneficiaries to their health care team. MiCare allows patients to request their next appointment, request medication renewals, receive test and lab results, communicate on-line with the health care team about non-urgent issues and request a copy of their immunization records. Patients can also receive a variety of messages including provider initiated messages, responses to patient inquiries with advice on non-urgent matters, and reminder messages for appointments. So are there proven benefits with patient portals? Absolutely! In 2007, the American Journal of Managed Care published the results of a study that included 4,686 adult members of Kaiser Permanente Northwest who were registered with their on-line health management system for 13 months and had used at least one feature. That study found that patient access to the secure messaging feature was associated with decreased rates of primary care office visits and telephone contacts. Specifically, patients were found to be up to 10% less likely to schedule a routine office visit, that they make about 14% fewer phone contacts, and that those who book appointments on-line are up to 50% more likely to keep their appointment. Now that's a prescription we can all live with!