Family Health Guy

In which Sean talks about HealthVault and other cool ideas in Personal Health

HealthVault: Certified Awesome.

HealthVault: Certified Awesome.

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Update December 2013 --- the team has put together a great document with all the details required to integrate solutions with HealthVault to take advantage of our certification; you can find it on our MSDN site here. ---S

EHRs aren’t the solution to our healthcare problems. But they are a necessary step on the journey, because you can’t use data to make things better until you have data. This is a point that Farzad was really good at making; I hope it doesn’t get lost in the inevitable political squabbles in front of us.

And despite its challenges and unintended consequences, I’m hard-pressed to come up with a better approach than Meaningful Use to move us forward on that journey. So I’m glad to offer the punch line for today’s post: HealthVault is officially certified to deliver Meaningful Use Stage 2 VDT requirements. And we do it better and cheaper than anything else you’re going to find on the market, so you should take a serious look.

Yippee --- but you may be legitimately asking --- WTF is VDT?

The purpose of the VDT or “View, Download and Transmit” measure is to help patients receive copies of their health information so that they can share it with other caregivers. Those “downstream” caregivers may be specialists, family docs, second opinions, non-traditional providers like naturopaths or nutritionists, family members, or even online support communities. The information may also be used with new mobile or web applications that help people take more control over their own conditions.

In other words, exactly what HealthVault was born to do.

The specific requirement is a little different for a hospital vs. other eligible providers. You can read all the gory details online, but basically it boils down to:

  • Visit information is available to at least 50% of patients within a few days of the visit, and
  • At least 5% of patients take advantage of their information and view it online, download a copy, or transmit it using Direct secure messaging to a location of their choice.

Seems pretty simple, but of course things get significantly more complex in real life. Compliant software has to present the information in a certain way, support key standards like C/CDA and Direct, keep track of which patients have and have not taken actions, and so on.

HealthVault makes this all that just go away. Get visit summary data to us, and we’ll take care of the rest. Because creating that C/CDA document is part of other measures already, that shouldn’t be a problem. You can then send the information to HealthVault over a number of channels:

  • Send it via Direct. If your patients already have a HealthVault account you can collect their address at registration time, or even easier you can just send to newuser@direct.healthvault.com and we’ll bootstrap the process for them (read more here and here).
  • Use our “drop-off / pick-up” API to stash the information away and give your patients a pickup code they can use from home to collect the information. Integrating this code into an EHR is super-easy, or you can run it stand-alone using a site like this one (source code included at that link).  
  • For a richer, ongoing connection --- you can establish a persistent link to HealthVault starting from your existing patient portal or using a Patient Connect workflow … and then send data automatically on every visit. Get started at http://msdn.com/healthvault.

 

And that’s it --- really. Using HealthVault, your patients can view their information online, download a copy, or send it on to others using our built-in Direct functionality. We’ll keep track of these actions, and on demand you can download reports that combine with your EHR data to document compliance.

But wait, there’s more. Not only is HealthVault the easiest and cheapest way to meet these requirements, but it has another built-in advantage over doing it in a proprietary patient portal or other tethered solution. Let’s look at a specific FAQ from the CMS site about VDT with an untethered portal like HealthVault:

If multiple eligible professionals or eligible hospitals contribute information to a shared portal or to a patient's online personal health record (PHR), how is it counted for meaningful use when the patient accesses the information on the portal or PHR?

...If an eligible professional sees a patient during the EHR reporting period, the eligible professional may count the patient in the numerator for this measure if the patient (or an authorized representative) views online, downloads, or transmits to a third party any of the health information from the shared portal or online PHR.  The same would apply for an eligible hospital or CAH if a patient is discharged during the EHR reporting period. The respective eligible professional, eligible hospital, or CAH must have contributed at least some of the information identified in the Stage 2 final rule to the shared portal or online PHR for the patient.  However, the respective provider need not have contributed the particular information that was viewed, downloaded, or transmitted by the patient.

So to be clear: all providers that use HealthVault as the means to address VDT requirements are working together towards their 5% participation number. If you play with us, each view, download or transmit of any relevant information in the PHR counts towards your measure --- whether it’s your specific information or not.

This isn’t a technicality or a mistake … the goal of VDT is to increase patient engagement and information exchange, and by doing so through an untethered PHR like HealthVault --- the information is more liquid, more accessible, and more powerful.

SUPER COOL!

Whether you’re an EHR vendor, HIE looking to support MU requirements for your constituents, or a provider or hospital figuring out modular certification --- we’d love to help. Drop me a note using the contact form on the blog here, or just email hvbd@microsoft.com and we’ll do our best. 

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  • As a fed we can't take a position one way or another for a vendor but anytime we see a systems solution to patient engagement like Health Vault offers we CHEER and do a Happy Dance.

  • Timely blog for some work we're doing in the UK - we don't have "Meaningful Use" (yet) but the principals are highly relevant. We'll be ready for MU (and Blue Button) when it comes !!

  • Can Healthvault address the core measure 17 in regards to the patient having the ability to send a secure message to the provider?

  • Corey, we couldn't certify HealthVault *on its own* for secure messaging, because the test scripts all revolve around what happens in the provider EHR systems (sending and receiving). However, we can be (and are in a number of cases) used as a component in certification for this measure --- that is, if the EHR can receive and send Direct messages, we can be used as the patient arm of that workflow.

    VDT was a bit different because the test started from the point that the C/CDA documents were available to the patients.

    Kind of a wonky technical difference, but that's always the way with these kind of things. Bottom line is HealthVault is *great* for secure messaging support a la MU2 ... it just needs to be tested in concert with the EHR itself to certify.

  • Hi,

    We are using HealthVault as our patient portal partner. We use master - child app model. We contribute CCDA using record authentication using patient connect method. We are already certified for MU stage 1 and we are planning to get certified for MU stage 2 as complete EHR.

    Since we use HealthVault as our patient portal, I believe we could demonstrate the MU criteria "§170.314(e)(1) View, download, and transmit to 3rd party" using HealthVault. If I am correct I have the following question based on the test script provided by our proctor.

    1. Need information about encryption algorithm and corresponding key length, hashing algorithm, and authentication method used by MS HealthVault while communication.?

    2. How to identify/find DCDT's Trust Anchor in MS HealthVault's trust store?

    3. How to identify/find the TTT's Public Key Certificate and Trust Anchor in the MS HealthVault's trust store?

    4. How to track the logs of the activities for the message sent from MS HealthVault?

    5. Where do I find the WCAG validation report for HealthVault? Which is the WCAG validation tool used?

    Thanks,

    Robert

  • Robert, I think it's even easier than these questions --- can you please forward your comment to me via email (sean dot nolan at microsoft dot com) so I can put you in contact with the right folks on our side? Thanks! ---S

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