Barbara L. Massoudi, Research Triangle Institute, BreathEasy Principal Investigator
Alex Krist, MD, MPH, a member of the BreathEasy team from the Virginia Commonwealth University Department of Family Medicine, recently published a commentary in the Journal of the American Medical Association (JAMA), “A Vision for Patient-Centered Health Information Systems” (JAMA, Jan. 19, 2011, Vol 305, No.3). In the commentary, he discusses the current state of patient-centered health information technology and proposes a model for a patient-centered health information system based on five levels of functionality (see graphic).
Upon reading the commentary, I started to think about which level of functionality the BreathEasy project falls into, or for that matter, which level any one of the Project HealthDesign projects would fall into. The highest level of functionality is designed to help patients take action — certainly something that fits well with the Project HealthDesign focus on observations of daily living (ODLs) and putting “tools” into patients’ hands. In describing this level of functionality, Dr. Krist says “Trust comes when the personal health record has the endorsement of the physician and is designed to seamlessly interface with care delivery, as when output is shared and the personal health record refers patients back to their physician for assistance or helps them prepare for upcoming office visits.” This is certainly the goal of most, if not all, of our projects.
Dr. Krist goes on to describe some of the challenges related to building systems that function at the highest level, including programming to personalize messages, cultural competency and integration with clinical workflow. These are all issues we’ve considered at length while working on the BreathEasy project. We’ll be conducting lab-based usability testing of our BreathEasy application with both patients and clinicians in the next couple of months, so we’ll soon see how we’re doing.