The Web-based Personal Medical Home

In the near future, here in San Diego, Mrs. Jones turns 50. She has a wonderful birthday. Her husband surprises her with many friends coming over to celebrate. That evening she decides to visit her personal medical home before going to bed.

She turns on her computer and goes to her personal homepage with her medical group. To her pleasant surprise, there is a big greeting, “Happy Birthday, Mrs. Jones! We hope you are feeling well today. Now that you have turned 50, you have new preventive medicine guidelines to consider.”

Mrs. Jones enters the “Preventive Medicine” section and clicks on a series of links that include her status with her mammograms, options for colon cancer screening, her immunizations, and other age-appropriate preventive measures. She is able to arrange for all of these preventive services by clicking on them, and she will be reminded of them until they are completed.

She then clicks on the “Healthy Lifestyle” icon. Mrs. Jones has been working on quitting smoking. In the “Stop Smoking” section, she reports that she has done what she promised, stopped smoking on her 50th birthday. Soon she will get messages from her stop smoking group with “You go girl, you can do it!” Her primary care physician or team member will respond, “Congratulations! Keep it up. Let us know at least once a week how you are doing. Contact us with any questions.” Lots of resources to quit smoking are available to Mrs. Jones on this link.

Since Mrs. Jones is overweight, she clicks into her “Weight Management” section and reports on the 1,200 calorie Mediterranean diet she has chosen to follow. As she enters her eating diary, she will get feedback on how she is doing. She also enters the “Physical Activity” section and reports on the five hours a week of exercise she has committed to. Her weekly weight is tracked, and lots of resources are available to her.

Because Mrs. Jones has hypertension and hyperlipidemia, she clicks into these disease management sections and reports her progress. She confirms that she is taking her daily aspirin, ACE inhibitor, and statin medications. She has pre-diabetes, so she enters the “Diabetes Prevention” area and looks at her progress and the resources in this area.

If Mrs. Jones gets an acute health problem, like a bladder infection, sinusitis, or a migraine, there is an icon for finding the most convenient way for these to be addressed.

There is an icon on her homepage with the smiling face of Mrs. Jones’ primary care physician. She may click on that to be connected to her and the entire primary care team. They share the same health information platform with her. Because Mrs. Jones was diagnosed recently with rheumatoid arthritis, there is also an icon with the smiling face of her rheumatologist, and she may click on that to be connected to him and his staff, again, with everyone sharing the same information platform.

The web-based personal medical home is an integrated health information platform with a triple convergence of three health information technologies: an electronic health record shared with the patient, clinical decision support imbedded in the record, and secure communication among all caregivers and the patient.

This is 21st-century, patient-centered care. It is based on deep relationships and powered by information technology. All of these applications are possible today. Which San Diego medical groups will lead the way in developing these applications for patients to actively coordinate their healthcare?