A standard-based model for the sharing of patient-generated health information with electronic health records

Abstract

This paper proposes a standard-based model for the automated collection of patient data using personal health devices and the secure sharing of these data with authorized providers' electronic health records (EHRs). The model addresses a number of important requirements for the practical collection and exchange of such data between patients and providers. The technical elements of the model are based on the features of personal health devices, health data repositories, and interoperability standards that already exist. For the automated collection of data from patients' personal health devices (such as wireless glucometers or smartphone-based applications), the model suggests a set of content standards developed by the Continua Alliance and already implemented in a number of commercial products. For the sharing of collected data with providers' EHRs, the model specifies a secure transport layer based on the DIRECT Project's secure email standards and an application data layer based on HL7 v2.5.1 query-response messages combined with the clinical document architecture Release 2.0 personal healthcare monitoring report implementation guide. All of these standards have been implemented and are in current use, although they have not yet been combined to meet the specific use case of sharing patient-generated health information with providers EHRs. The proposed standard-based model constitutes a "straw man" intended to foster thought, discussions, and refinement through pilot implementations and improvements.