Evolution of myDMR
Before creating myDMR, our product development team designed and developed an enterprise solution for electronic consent management (eConsent) for use in the public health sector. This solution continues to serve a large teaching hospital, a health information exchange, and a jurisdiction of approximately 14 million people.
Around 2012, the team turned its attention to a treatment challenge that occurs when a patient presents for care at an emergency department (ED) or clinic outside their family doctor’s office: lack of clinical information about the patient.
Common Emergency Department Challenges
Use Case 1
Bob, a Florida resident, travels to Colorado to go skiing. He breaks a limb and presents at a Colorado ED for treatment. He’s on a complex regimen of medications but doesn’t remember the details.
Use Case 2
Jasmine, a Michigan resident, visits her sister in North Carolina. While there, she has a stroke and is taken to the ED, incoherent. The ED doesn’t know that she’s allergic to codeine and has cancer.
It would be beneficial for the ED staff to quickly have access to clinically derived information on these patients – information about their allergies, pre-existing conditions, and what medications they currently take – where the origin of the information is not called into question.
myDMR contains clinically-sourced information, not patient-generated health data.
wallet card (front)
wallet card (back)
We initially developed myDoctorsMedicalRecord (myDMR) as a solution to allow providers outside of the patient’s usual care team to access that clinical information when needed, with the consent of the patient (patent).
A standards-based summary care record is securely sourced from the family doctor’s EMR and encrypted and stored in a cloud-based clinical document repository. It can be viewed when the patient presents for care and provides their myDMR wallet card. If the patient is incoherent, it can be viewed when given an authorization code by the patient’s emergency contact.
This provides the ED staff with information that is current, clinically relevant, and actionable. From the patient’s perspective, it’s their direct, private, and secure view of my doctor’s medical record.
Supporting Primary Care
After several years, we evolved the product to address a rapidly-growing need in healthcare: care management tools to better enable primary care practices to prevent their chronically ill patients from presenting at hospital emergency rooms.
Primary Care & Chronic Care Management
According to the Centers for Disease Control and Prevention (CDC), the chronically ill are the most frequent visitors presenting for emergency care. The Centers for Medicaid and Medicare (CMS) states that one in four Americans has two (2) plus chronic conditions. Two-thirds of Medicare beneficiaries have two (2) plus chronic conditions, with 99% of total Medicare spending being on patients with chronic conditions.
Primary Care – The Patient Centered Medical Home (PCMH)
According to the collaboration of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA), care coordination is an essential component of the PCMH. “It requires additional resources such as health information technology and appropriately-trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their functions devoted to care coordination activities and patient-centered care management that fall outside the face-to-face patient encounter may help encourage further coordination.”
CMS – Chronic / Principal Care Management Billing Codes
In 2015, to stem the leakage of these patients from primary care, CMS introduced the first CCM billing code (CPT 99490). The idea was to incentivize primary care to spend more time (non-face-to-face) with those in their patient panel with two (2) plus chronic diseases. Since then, CMS has added billing codes for PCM to accommodate patients with one (1) chronic disease. They also added more billing codes to compensate doctors for the added time spent on developing complex and non-complex care plans, the added staff necessary to provide monthly non face-to-face care, and remote patient monitoring.
Primary Care Solution
myDMR Care Management
In recent years, our team extended the ED use case functionality into a fully featured cloud-based care management workflow solution. And while CCM and PCM are the focus, every CCM/PCM patient gets the wallet card included with the cost of subscription. This enhances patient safety and provides something tangible to put in the hands of the patient after they have enrolled in their doctor’s CCM or PCM program.
myDoctorsMedicalRecord (myDMR) is operated by HIPAAT International Inc., a Delaware corporation registered for business in the State of Florida.