0.2.3 - ci-build
HealthDataReceipt - Local Development build (v0.2.3). See the Directory of published versions
Patient Data Receipts are modeled after physical receipts, both financial and workflow oriented. Data receipts are a form of metadata, and like a physical receipt, don’t transmit the actual thing itself (in this case, protected health information). Rather, the receipts inform that a purchase or event occurred, and provides some metadata and provenance about the event - usually involving basic information regarding who, what, when, where, and how much.
Patient Portal
John Smith signs up for an online service called a Health Manager that promises to help him with his health and healthcare by tying together his health data in one place and giving him control over it, including the ability to correct, enrich, and share it. Upon signing up, Health Manager informs John that organization that collect his health data are required to make it available to him and that he can designate Health Manager as the recipient and custodian of his health data. John starts with his smart phone, which tracks some health data such as activity and how much he uses his phone. The next time he visits his PCP, John asks about making this designation and successfully records Health Manager as the destination for data collected by his PCP.
In response, data starts flowing into his Health Manager. His smart phone provides a daily summary of his per-app usage of his phone and other movement data. Each time he sees his doctor or gets a test result, that information flows into his Health Manager as soon as it gets recorded. Other organizations provide additional health-related information, helping to build a detailed record of John’s health all under his control and for his use.
Wearables
Mr. Smith is very active and health conscious. He religiously wears his wearable, which tracks his step count, heart rate, O2 saturation and sleep patterns. Every evening when he charges his wearable, the data is sent to his Patient Data Manager.
Health App
After the fall, Mrs. Smith decided it was important to establish her son as Health Care Proxy. Using Cake, she identifies the relevant form for New Hampshire, prints it out, executes it and uploads it to Cake. This also triggers that executed Health Care Proxy to be sent via Cake to the Patient Data Manager. Mrs. Smith is able to share the Health Care Proxy form with her husband and son.
Besides their requirement in crossing international borders, vaccine cards in recent years have been used to screen entry into restaurants, entertainment venues, and other spaces where large numbers of people gather. CDC Vaccination Cards provide a textbook example of a clinical receipt of having had a medical procedure performed that’s in the interest to public health.
Mr. Smith just learned he is qualified for a 2nd COVID Booster shot. He visits a local pharmacy to receive the shot. Immediately following the shot, Mr. Smith is given proof of vaccination with a QR code. Mr. Smith scans the QR code and documentation of the 2nd COVID Booster is sent to Mr. Smith’s Patient Data Manager. He is able to provide proof of vaccination via cell phone that evening when going to his grandson’s musical performance.
Various out-of-network or out-of-pocket procedures may involve obtaining healthcare data from outside the established primary care environment and trust network. These consultations can range from lab exams to consultations with specialists for rare conditions. At the end of the visit, a diagnosis or prescription is sometimes given. When signed (either cryptographically or via signature), the resulting document acts as a clinical data receipt, suitable for being excused from work or school, and usable as evidence in a court of law.
Appointment Reminders
A common practice at clinics is to have a stack of blank business cards that are designed as appointment reminders. The receptionist or scheduling manager is typically tasked with filling out an appointment reminder card and giving it to the patient on completion of scheduling their next visit. This card acts as a data receipt of having been scheduled and reserving a time in the future with the care provider.
Consultation Results
Mrs. Smith has a fall and quickly develops a hematoma on the forehead. Her son applies ice to the hematoma and takes her to a nearby hospital ER to be evaluated. Upon examination by a physician assistant, the hematoma appears to be superficial. However, Mrs. Smith gets a CT Scan to confirm there is no internal bleeding. The CT scan reveals no serious injury. She is bandaged, advised to take Ibuprofen as needed and sent home. Within the hour, a Patient Data Receipt (including CT Scan images, radiology report and care instructions) is sent to Mrs. Smith’s Patient Data Manager.
Telehealth
Mrs. Smith wakes up in the morning and feels slight dizziness. She also had frequent trips to the bathroom the night before. Upon checking her blood pressure, it’s elevated at 174 / 85. She calls her PCP office but he does not have any available appointments until next week. So, Mrs. Smith decides to initiate a telehealth session with a provider. She is able to share with the telehealth provider her family history of hypertension, current med list, and blood pressure readings for the past 2 weeks. Upon discussion, they are able to isolate the problem to be high salt intake the day before. She is instructed to watch her diet and measure her blood pressure 2x a day (morning and evening) and follow-up if she experiences any new symptoms. Immediately following the encounter, the notes from the clinical encounter are sent to the Patient Data Manager.
Over the Counter Purchase Receipts
Professional clinicins spend a disproportionate amount of their time managing controlled substances and performing procedures that cary a risk of bodily harm if done incorrectly. However, for the patient, managing such activities is often a small percentage of their overall health management. It’s extremely common among the population as a whole, for the bulk of any individual’s day-to-day healthcare spending to be on over-the-counter medications and supplies. IRS and other organizations ask to see financial receipts when calculating medical expense deductions. And from this branch of law can we understand over-the-counter purchase receipts as a form of data receipt for non-regulated or semi-regulated substances.