Transforming Care Delivery: Best Practices

Whatcom County, Washington

A plan to enhance provider-patient communication is already reaping rewards in Whatcom County, WA, by allowing individuals to collaborate with their families, health care professionals and others involved in their care through an online personal health record.

My Shared Care Plan (SCP) facilitates communication between patients and health care professionals to support long-term planned care for patients with chronic disease. Funded through a Pursuing Perfection grant from the Robert Wood Johnson Foundation in 2002, SCP began as a paper-based record that patients “invited” into the program could use to fill in information about their care team, diagnoses, medications, history, reactions and even advanced directives.  The patient and his health professionals can access the record online, as well as individuals who are designated as important to the patient’s care, such as relatives or neighbors.

After some tweaking and consultation with participants, SCP was rolled out as an online personal health record that encourages patient self-management.  Although SCP is not openly advertised, some 650 patients are now using the electronic version.  A sample patient record is available at www.sharedcareplan.org.

The program is operated under the Whatcom Health Information Network, LLC (HInet).  HInet began in 1991 as a community-wide commitment to collaboration to achieve seamless care in Whatcom County.  In 1995, the county’s only hospital, St. Joseph’s, and about 80 physicians went live with a comprehensive electronic medical records system.  HInet now provides the infrastructure for electronic health information exchange for St. Joseph’s and about 2,000 other provider users.

“The Shared Care Plan was developed by patients through the grant process, and we’ve been modifying the application based on patient feedback and modifying support materials before we throw the doors wide open to everyone,” said Lori Nichols, HInet and Pursuing Perfection program director.  Any patient in Whatcom County is eligible to use SCP, and Nichols said there are plans to make it more broadly available in the future.

In a recent survey of SCP participants, 80 percent reported that having a SCP helps them organize and keep track of their healthcare information.  More than 77 percent reported that having a SCP helps them take a more active role in their own healthcare.  More than 72 percent reported that having an SCP helps them communicate with health care professionals.  Three out of five said they bring a printed copy o their SCP with them when they visit their health care providers.