In British Columbia’s complex healthcare system, patients often access disparate services from multiple providers, making it difficult to access or manage their own medical information. This is especially true for rural patients who often access healthcare services virtually, or in other communities. To enable patients to easily access and manage their medical records—and place them at the centre of their health journeys—the Rural Coordination Centre of BC (RCCbc) launched a new Rural Personal Health Record (PHR) project in 2020.
This month, we sat down with Jess Rothenburger, Rural PHR Project Manager, to learn more about personal health records, the Rural PHR project, as well as his motivation for joining the project and its vision for the future.
Q: Jess, let’s start with the basics. What’s a PHR?
A: A PHR is a holistic and integrated electronic health system that allows people (and those who support them) to access their health information so they can better manage their health and wellness. We’re advocating for the development and implementation of a PHR across British Columbia, but we’re primarily focused on amplifying the voices of rural, remote, and Indigenous communities to help ensure that a PHR meets their unique needs.
Q: How could the implementation of a PHR improve health outcomes for rural British Columbians?
A: By having easy access to their own information, a person could better manage and take greater interest in managing their health; the patient can become the protagonist of their own health journey. A patient could be better positioned to access care, understand risks, interact with their health providers, improve their health literacy, and more. By granting access to their information to family members, caregivers and providers, a patient can use a PHR to facilitate partnerships and create a team of care. And, as rural patients travel long distances to access care, having their information travel with them can prevent errors and gaps when information may not seamlessly flow between different providers and health authorities.
Q: Tell us about the Rural PHR project—what is it striving to achieve, and what key steps is it taking along the way?
The Rural PHR project is a partnership between the BC Ministry of Health’s Patient Empowerment Pillar and RCCbc. We’re striving to put rural, remote and Indigenous communities at the core of PHR development in British Columbia. We’re creating a technical roadmap and working with diverse stakeholders and, directly, with communities to prototype real-life solutions that help patients access their information and manage their healthcare. This will help ensure that rural patients and communities are better positioned to participate in their own healthcare stories, and that solutions are developed to address the unique needs of rural, remote, and Indigenous communities.
Q: Where are you and the team currently at with the Rural PHR project—and what has the response been, so far, to the idea of a Rural PHR?
A: This is an aspirational project, to be sure. COVID, provider fatigue, and the developing provincial standards framework are real challenges, but as we’ve engaged with patients, providers, vendors, administrators, policymakers, and directly in rural communities, it has become abundantly clear that PHRs are in our future—hopefully sooner than later. Experts on our team have worked hard to help make sense of the current state, and we’ve engaged directly in community to find out patient and provider needs. By aligning what’s technically possible now with the priorities of community, we’re supporting the implementation of PHR in Valemount, and looking to repeat this process in other communities. Concurrently, we’re developing a technical road map with a vision to diffuse the benefits of a PHR more broadly.
Q: On a personal level, why are you passionate about this project—about the development and implementation of a Rural PHR?
A: I feel lucky to have debuted my work in this sector as the project manager for Rural PHR, particularly because this project reflects, in practice, the wisdom modelled by my colleagues. This project resonates with me because it’s centred on the patient and grounded in its intent to empower people. As the iterative development and adoption of a PHR increases, the practical benefits to patients, providers, and to the system will become evident and, ultimately, result in better health outcomes. But the prospect that a PHR can help transform the culture of our healthcare system to become more patient-centred is what fires me up the most.
Q: You joined RCCbc just eight months ago—and came from outside the healthcare world. How does this impact your perspective on the Rural PHR project?
A: Being relatively new, I can easily see all the professional, committed, and caring people who work hard with the unifying goal of improving people’s health, working in a very challenging and complex sector. I see people striving towards equity, inclusion, justice and reconciliation. I confess that being just new enough hasn’t afforded me any unique insights. I can share my admiration for the work that’s already been done, re-affirm my resolve, and lean into the wisdom of my mentors. I’ve always been interested in looking at how people, especially the most marginalized, find innovative ways to solve problems. And I’ve always believed that solutions for people work best when they operate within a system that, itself, is centred around the people for whom the solution is created. In this regard, the Rural PHR Project aligns well with me because PHRs not only present the opportunity to help people, but also to continue nudging the system towards being more patient-centred.
Q: What hope do you think a Rural PHR would give to a complex health system, like British Columbia’s?
A: To be sure, a PHR won’t magically or suddenly transform our system. And given the graveyard of unsuccessful attempts at PHRs, our project team works optimistically, but unassumingly, towards this bold vision. But a PHR can be an important tool—one of many working in combination that can lead to meaningful change and positive health outcomes. Interoperability, standardization, product development, change management… no doubt there’s a lot of work to do, and none of this is easy or guaranteed. But all the more reason to try! But, fundamentally, what a robust PHR could do is make it easier for patients, and those who support them, to better manage their own health. Ultimately, this could lead to better health outcomes for British Columbians.
