CORAnet Solutions Champions Patients’ Medical Record Access with Its Personal Health Information Exchange

Marc WineIt has been six years since the HITECH Act passed, yet most Americans seeking medical care are still unable to obtain their full medical records for a variety of reasons whether the hospital will not release them or proprietary EHR system vendors will not allow hospitals, let alone patients, direct access. One Healthcare 2.0 leader, CORAnet Solutions, has developed a tool that finally allows patients access to their complete medical records. This new breakthrough technology enables patients to take control of their personal medical data with CORAnet’s Personal Health Information Exchange (PHIE).

This mobile device based technology that meets HIPPA security standards and enables direct access to any existing patient electronic medical record in any system that is running an open Application Program Interface (API). CORAnet fills the gaps in interoperability across networks and platforms without waiting another decade or a single day for the individual, as well as hold the promise of providing individuals true ownership and control of their medical records.  

By leveraging the powerful simplicity of open source technology, CORAnet’s PHIE software can access medical records in a way that is much more comprehensive than the closed EMR portals commonly used by doctors’ offices. Despite their pervasive use, these portals are cumbersome and expensive for patient’s use. The portals also include the same lack of interoperability that plagues hospital EHR systems.

Ready to Deploy

CORAnet’s original PHIE prototype was deployed in flash drives that required readers and laptops. However, riding the digital wave of Healthcare 2.0 innovators, CORAnet migrated to a mobile platform when smartphones and later tablets came into the market.

While the ONC roadmap does not promise interoperability until 2024, CORAnet can deliver consumers their data now, into their own hands. This breakthrough is now ready for full-scale mobile deployment; challenging every consumer health organization, third-party payer, hospital, ACO network, and Congress to recognize the need for open solutions and include the PHIE in its plans as it moves away from proprietary systems. Adoption of this tool also demonstrates the healthcare industries’ commitment to allowing patients access to their own records, freeing their control by large EHR vendors, as advocated by medical industry thought leaders such as Dr. Donald Voltz as oulined in an article titled "Why I Hope to Help End EHR’s Lack of Interoperability."

CORAnet’s Mobile PHIE is readily available to lead in the consumer health information campaign for change, interoperability now, quality and safety through license relationships with hospitals, payers, telecommunications companies, mobile device firms, and large employers. Additional channels may include integration with leading EMR systems, integration with Health information Exchanges including the HealtheWay Collaborative, VAR agreements with health and wellness IT firms and application distribution through the online marketplace (Google Play and iTunes).

Lack of Interoperability Continues to Hamper Patient Record Access

This capability also comes at a critical time as enormous obstacles hamper the ability of people to obtain their medical records stemming from blockage by proprietary EHR vendors, major hospital corporations, and laboratories. This is documented in a recent report published by the ONC. The 2015 Report to Congress on Health Information Blocking concludes: “it is apparent that some health care providers and health IT developers are knowingly interfering with the exchange of health information in ways that limit its availability and use to improve health and health care.”

This situation is only going to worsen as the Centers for Medicaid and Medicare (CMS) is considering a change to the EHR meaningful use rule that requires “5% of patients must view or download or transmit” their health data to “only one patient” -- not 1%, one patient.”  This dysfunction has even caused the EHRI Institute to cite incorrect or missing data in EHRs and other health IT systems as the second highest safety concern in its annual survey just released, outlining the Top Ten Safety Concerns for Healthcare Organizations in 2015.

PHIEs as the Solution to Health IT Interoperability

The PHIE concept has been around for a while. A 2009 Health Affairs article—What It Takes: Characteristics of the Ideal Personal Health Record detailed the major factors behind the slow adoption of Personal Health Records (PHRs). The article reviews some of the reasons and includes cost, access, interoperability, security concerns, and data ownership. But the major factors where lack of open designs and open engineering. These factors led to products with limited value to the end users. Unfortunately, little has changed.

Because health information, such as clinical data, laboratory results and medical images do not flow freely among multiple organizations, PHRs do not automatically receive data. This means that the data must often be entered manually by consumers—a time-consuming and error-prone process. For most consumers, this lack of safe and reliable automation makes it problematic to maintain a PHR, and a PHR that is not up-to-date likely will not be used.

The authors of the Health Affairs article offered a challenge. They described a gap between today’s personal health records (PHRs) and what patients say they want and need from this electronic tool for managing their health information. They noted that until that gap is bridged, it is unlikely that PHRs would be widely adopted, but noted that in the future, when these concerns are addressed, and health data are portable and understandable (in content and format), PHRs will likely prove to be invaluable.

CORAnet Takes Up the PHIE Interoperability Challenge

Cora Alisuag, CEO of CORAnet solutions, took up the challenge and began implementing a variety of open mobile solutions for the PHR industry. The ONC, through White House Fellow Adam Dole, recognized CORAnet as a truly innovative Blue Button Connector. Meanwhile, Dr. Paul Tibbits, Deputy CIO, Architecture, Strategy & Design, Office of Veterans’ Affairs, credited CORAnet as the foundation of the mobile Blue Button PHR technology. CORAnet has issued patents in the U.S., China and Canada and a patent pending for connecting wearable sensors to the CORAnet platform.

CORAnet Open Technology Product Family

In order to overcome the lack of interoperability obstacles that proprietary vendors have erected to health data sharing, CORAnet has developed a system of mediums for using its products for maximum mobile convenience—the CORAnet website, mobile platforms and the servers residing in the cloud for traditional PC platforms.

To access the system, users create an account in the CORAnet website that provides basic profile information, identifies the points of contacts and locations of their medical data. It then quickly and conveniently downloads the applications to their mobile device.

The CORAnet™ Integration Server (IntegServer) is the heart of CORAnet’s technology. It is the primary integration layer that allows the consolidation of information from different EMR systems (which have their own proprietary protocols) into one cohesive medical profile that can be easily accessed. It consolidates and organizes medical data as a single personal health record (PHR), secured with 256-bit encryption to the patient’s smartphone, and tablet where medical data can be stored and accessible anytime, anywhere—online and offline. It automatically updates to medical records which are then ‘pushed’ to the device every 24 hours. The uniqueness of the technology is that data is stored in the mobile device and EMR sources only. This guarantee patient privacy and ensures HIPAA and other regulatory compliance, the CORAnet servers do not store the actual medical data.

It is important to note that individual patients cannot change any source-identified data originating from the EMR system. This ensures absolute data integrity. However users are allowed to add or delete allergies and medications that do not come from the many different sources, but the system will identify it as self-entered.

It allows sharing of data to different care providers when the patient visits multiple specialists by email, print or through a common EMR system. If the user chooses to share EHR data by email, the system creates a PDF file that can only be opened by using the system generated password. It allows family sharing of data (with consent), and with its notification feature, individual patients and trusted third party are reminded of their appointments and medication intake thereby facilitating patients’ compliance in their care.

CORAVault provides access to disparate electronic health records, CCD, CCR, and HL7 files securely from different locations such as hospitals, clinics, pharmacies, and physician practices. It is the ambulatory component that provides access to disparate EMRs from many different sources as a single, organized view in the patient’s mobile device (smartphone, laptop, or tablet). This view may be accessed on demand, 24/7 even without network coverage.

CORALink is a life-saving in Case of Emergency (ICE) Solution that allows first responders, rescue and ER personnel to quickly access your crucial life-saving information such as name, date of birth, blood type, emergency contact, allergies and current medications in emergency situations where you’re unconscious or unable to speak. Quick access to records can be lifesaving if an emergency occurs and answers to those questions are critical during the first responder decision making process.

The CORALink notification feature can be readily used with the click of an icon— emergency contacts can be notified immediately.

In summary, the CORAnet technology features and benefits include:

• Users do not have to manually enter their data. The system extracts it automatically in real time from EMR open API sources (including frequent updates).
• Reminder features for medications and appointments to both trusted third party and the patient that can facilitate engagement in care.
• The system is mobile, secure, and accessible anytime, anywhere offline and online.
• Excellent for people with chronic diseases who travel a lot and see many different doctors and care providers.
• Allows family sharing of data. Patients can share their data with anyone they choose, e.g., their doctors.
• Data is encrypted, username and password protected.
• Allows transfer of images such as nuclear and CT scans, radiology images and non-invasive procedures such as EKG.
• Data integrity is assured as data that came from the identified EMR sources cannot be changed by users.

As devices become more sophisticated and application providers design mobile-ready solutions, the mobile “open way” may also serve as an important entry point for consumers to access their health data. The mobile exchange that CORAnet delivers also introduces an important opportunity to support consumers in behavior change through direct and customized decision support interaction including interoperability with multiple sensors and monitors across domains and the environment.