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Treatment, a Vancouver-based online medical informatics company working in a new market called patient self-care, is developing a unique suite of online and integrated patient decision support products and services. Treatment has developed a new technology called a personal health record (PHR), a patient-centric, private and secure health record that the patient owns and controls. The PHR allows a patient to keep a lifetime chronological record of their own health record including family members, as well as chart immunizations, medications etc., and can be viewed by their own doctor, emergency room doctor or specialist online. The PHR lay's the foundation for supporting chronic disease management as these tools become available to patients, allowing improved management of their own illness TreatmentRecord is offered online directly to patients for $4.95 a month and from their physician’s office through partnership arrangements.
Focusing on patient decision-making
Patient self-care defines a primary care practice model that supports patients, in collaboration with their family doctors, in the discovery and self-direction of medical treatment plans specific to their illnesses. Treatment’s founder, Dr. Robert Scott, believes the best way to change the behaviour of patients and improve their health outcomes is to enlist patients directly in self- management of their own healthcare. Giving patients tools that give them better control of their own healthcare decision making and which provide equal access to medical knowledge as the physician, is the future of healthcare delivery.
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"Self-care involves the range of activities individuals undertake to enhance health, prevent disease, evaluate symptoms and restore health. These activities are undertaken by lay people on their own behalf, either separately or in participation with professionals. Self-care includes decisions to do nothing, self-determined actions to promote health or treat illness, and decisions to seek advice in lay, professional and alternative care networks, as well as evaluation of and decisions regarding action based on that advice." [2]
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Treatment is developing tools that patients can use, on their own, to help them self-manage their own treatment decisions. Internist Kevin Patterson wrote in the New York Times Magazine, “The instant the practitioner stops saying, “I think you should take this therapy,'' and starts saying, ''The evidence is that this therapy will work this percent of the time, with these complications, this frequently. What do you want to do?'' then the power hierarchy of doctor over patient is collapsed, and autonomy is assigned to the patient.’ [1]
Treatment Portal
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Patient self-management is typically defined as the individual self-management of symptoms, treatment, physical and psychosocial consequences, and related lifestyle changes encountered in living with a chronic condition. The patient is the primary interface for healthcare practice and research. Advances in biomedical knowledge, coupled with best-treatment evidence and delivered by distributed networks of healthcare information and biomedical devices, enable patients to undertake more personal responsibility for medical decision-making and ongoing health maintenance activities.
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TreatmentRecord - (personal health record)
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Treatment has developed a unique patient search engine that provides an ‘individualized’ decision support system for best treatments using evidence-based medicine drug treatment content. The product is in Beta form and allows a patient to scroll over a series of treatment options linked to their exact diagnosis ‘before’ they search, thus greatly enhancing the chance they will find treatment results on the internet that are meant for their precise diagnosis. This experimental tool deploys a new patient-based taxonomy of diseases and their potential treatment options that links the existing World Health Organization’s ICD-10 code to a patient directory of diagnoses and actual treatment options. The treatment options provide evidence-based drug treatment information to the patient with informed knowledge provided by a team of pharmacists. Both the PHR and TreatmentSearch form the basis for Treatment’s R&D efforts in the new area of Patient Self-Care.
Applying clinical informatics standards
TreatmentRecord uses a new emerging ASTM standard called the Continuity of Care Record (CCR). The CCR was developed out of the need for a clinical standard for the expression and exchange of medical information. The issue of standards is crucial in informatics. Standards allow developers to create products that speak to each other. The American Medical Informatics Association’s recent announcements outlining the creation of a Global Trial Bank and standards for clinical decision support set the stage for the development of chronic disease management guidelines that are interoperable and evidence-adaptive.
Chronic disease care takes a disproportionate financial toll on the Canadian healthcare budget. Best-practice guidelines for the management of such chronic diseases as diabetes, congestive heart failure, hypertension, asthma and others are being developed by provincial governments and in BC, offered on a financial incentive basis to family doctors to encourage their use with patients. Adapting these clinical practice guidelines to self-management by the patient is key to broadening the impact chronic disease management care will have on lowering healthcare costs while improving outcomes.
With Development Opportunities
Systematic investigations of primary care, practice-based, patient-focused research issues are the foundation of new product development by Treatment. The company’s research program’s in patient self-care and self-management of chronic diseases will lead to future products that improve the health literacy, decision-making capabilities, and wellness of patients.
Treatment welcomes partnership opportunities with companies interested in expanding their consumer presence or collaborating with Treatment on novel research initiatives. Currently, the company is offering partnership arrangements to co-market their new product, TreatmentRecord which can be integrated into any existing medical software system providing a valuable new tool for the consumer to use while giving companies a powerful new marketing product and recurring source of revenue. The company website can be found at www.treatment.com and Dr Scott can be reached at rob.scott@treatment.com.
References
- Patterson, Kevin, "What Doctors Don't Know (Almost Everything)", New York Times Magazine, May 5, 2002.
- Dean, K., Self-care behaviour: Implications for aging. In Self-care and health in old age: Health behaviour implications for policy and practice , ed. K. Dean, T. Hickey and B.E. Holstein, 58-93. London: Croom Helm, 1986.
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