“Our research shows that patients like having a direct connection to their physician. A shared connection is what consumers really want,” Martich says. “They want to communicate directly with them, get their lab results in a timely fashion, and see their appointments. They like seeing what their doctor sees.”
UPMC’s HealthTrak system was developed in-house six years ago through a grant from the Department of Defense, because the health system treats many military patients. UPMC uses Epic’s EMR system, and the UPMC HealthTrak PHR was built on the framework of Epic’s MyChart PHR. When Epic developed its MyChart patient portal, the health system linked its PHR to MyChart and the EMR. The PHR allows patients to see their lab results, vital signs, appointments, and most other data in real time, as soon as it is available to the physician, with the exception of MRI, CT, and radiology results. In addition, patients can correspond directly with the doctor, who is expected to reply within one business day.
Another question involves who is going to pay for this access. There are fee-based models for PHRs, in which the patient pays for the right to access the system, but Martich says UPMC patients were not interested in paying—even though they are enthusiastic about the PHR when it is free to them. UPMC does charge $40 for e-visits, in which an established patient with a new condition fills out an online form for 21 possible diagnoses and submits it to the physician for evaluation.
Epic charges UPMC for each patient using the PHR linked to its EMR, but the health system does not pass that expense on to the user. The charge is approximately $2 per year per patient, Martich says.
Once your PHR is in place, how do you engage both patients and physicians in using it? More than 1,100 physicians at UPMC use the Epic EMR, and they are encouraged to have their patients sign up for the PHR. The health system fosters participation by both patients and physicians by holding tutorials during staff meetings and having contests with a prize—such as a catered lunch for the staff—for the physician office that signs up the most participants.