Company News / Thought Leadership

Our Vision for a PHR

May 12, 2019

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The original vision for Zesty started in the summer of 2012 focused on primary care, private healthcare and building a two sided marketplace connecting doctors, dentists, physios etc with patients. Our view nearly 7 years ago was to solve the availability problem and unlock the thousands of ‘hidden’ appointments available to patients and consumers in their local area. 

Zesty expanded from 2013 to 2016 into 20+ primary care focused specialties ranging from sexual health to mental health, osteopaths to podiatrists and successfully launched in the majority of large towns and cities across England. Some of the key lessons we learnt in the early years were the need to integrate into clinical systems and patient records, the benefits of involving patients and clinicians in the design, user experience and user interface process, removing friction for patients, admin staff and clinicians, the power of web based applications not native mobile apps. 

Integrating into clinical systems– over and over again we were told by clinicians and support staff that integrating our product into their PMS, PAS or EPR system was the key to adoption and success

Involving patients and clinicians in design, UX and UI– we are all consumers, feedback from different user groups is key to removing friction, understanding features in detail and generating feedback for product roadmaps

Removing friction for patients, admin staff and clinicians– every day and week we witnessed the positive impact of removing friction – saving people time, helping them automate regular tasks etc..

Power of web based applications not native mobile apps– web based applications consistently outperformed and outgrew native iOS and Android apps over time, we experienced 60% of users on smartphones and 40% on tablets

In 2017 we started to focus on secondary care, specifically outpatient departments and digitally transforming the patient experience at 2 leading NHS Trusts, Milton Keynes University Hospital and Guy’s & St Thomas hospital. This was the beginning of our journey into the world of PHR’s, we quickly saw the benefits of allowing patients to manage their care and communicate with health providers digitally.

In the last 2 years we have worked with more and more NHS Trusts, patients and clinicians to co-design and co-develop a beta version of our PHR and plan to release the first version in the next 12 months. A big thank you to everyone who has helped us on the journey so far, we have a long way to go but appreciate all your help and advice.

A special mention needs to go to Professor Martin Severs, our recently appointed Chief Medical Officer. Martin has recently retired from NHS Digital and brings a wealth of experience and boundless energy to the Zesty team, as well as a substantial knowledge base around PHR’s, medical records, data access, consent mechanisms and patient advocacy.

We are very excited Martin has joined the team to help us realise the PHR vision. 

We believe a personal health record, managed and controlled by the patient at an individual level is the key to patient centric care and unlocking the massive potential of digital health interoperability. Our vision of a personal health record is active participation and differs to a ‘person held record’ which we see as more passive interaction.

We share the Royal College of Physicians definition of a PHR as being ..

… a digital tool that helps people to maintain their health and manage their care. It may do this by enabling them to capture their own health and care data, to communicate with health and care services, and/or to have access to their care record. 

Source : https://www.rcplondon.ac.uk/projects/outputs/personal-health-record-phr-landscape-review

Maintaining health : keeping a diary or journal, adhering to treatment tasks and daily prescriptions

Managing care : managing appointments (face to face and virtual clinics), pre-visit surveys, protocol driven questionnaires, sharing clinical and non-clinical letters

Capturing health and care data : adding connected device, sensor and IoT data

Communicate with health and care services : secure messaging, asynchronous chat

Access to care records : view and share GP, hospital and community held medical records

Zesty PHR 

Giving patients ownership of their health records is a good thing. But it’s only half the story. By combining intuitive sharing, dynamic consent management, transaction support and native support for a host of third party apps and devices, we think we’re building something truly special.

Our product vision is focused on 4 main feature sets – appointment and prescription management, letters and documents, virtual clinics and connected devices.

Combined, we believe the Zesty PHR product will be the UK’s market leader, saving the NHS and healthcare providers millions of pounds, patients a lot of time and worry, clinicians valuable time and resources.

PHR’s around the world

PHR’s have been around since 2010 in both the US and Europe. More recently Asian countries have launched PHR’s and are now actively adding more features and functionality for patients and users.

Google launched its standalone PHR, Google Health, back in 2008 as health IT began to gain traction through government incentives. However, the company failed to spark consumer interest, and eventually shut down the product on January 1, 2013.

While there were multiple factors that may have led to Google Health’s demise, limited provider interaction with the data and few motivational components were arguably most significant.

“Google basically offered a place to store data,” said Adam Bosworth, an original Google Health developer, in a 2012 interview with TechCrunch TV.

“Our data shows people don’t really want a place to store data, per se,” Bosworth continued. “They want to do something fun and engaging. If it’s not fun, if it’s not social, why would they do it? Yes, they want to be healthy, but they need more than that. They need the encouragement and even the pressure of friends. They need the constant pressure, constant reminders.”

Today, one of the biggest success stories for PHR’s in Europe is in Finland. The Finish Personal Health Record will enable citizens to enter their own health-related data in Kanta, national eHealth infrastructure designed for healthcare, social services, pharmacies and citizens. Kanta today has around 700,00 active users and is widely regarded as the largest PHR in Europe.

Estonia has developed a number of e-services throughout the years. The most widely used e-services are the Electronic Health Record, the Patient Portal, the digital prescription, the drug interaction decision support, e-consultation and e-ambulance. All citizens have had a nationwide Electronic Health Record since 2008. Doctors are mandated by law to transmit data to this online health record. All of a patient’s relevant health data is gathered in the record such as their recent appointments, analyses and diagnoses, time-critical data such as allergies, prescriptions etc. 

Looking further afield to Australasia, countries like Singapore and Australia have launched patient/citizen controlled and accessible PHR’s to decentralise medical data repositories and empower people to more actively their care.

Looking Ahead

Zesty is embarking on an exciting 2 to 3 year journey to deliver on our vision for the UK’s first fully transactional PHR. Connecting primary, acute and community care data with patient reported data and connected device data in one patient managed and controlled PHR will no doubt create significant value and benefits for all stakeholders involved.

We are actively hiring developers, product managers, business analysts and many more roles over the next 12 months so feel free to email us on jobs@zesty.co.ukif you would like to help us deliver our vision and build an amazing product.

Team Zesty!

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