Health IT tools can help patients take responsibility for their health, but technologists need to meet them halfway with imaginative, easy to use programs.
Under healthcare reform, clinicians are expected to be more accountable for the quality and value of care they offer patients. Healthcare providers participating in accountable care organizations (ACOs) can only expect to be reimbursed if they can produce good clinical outcomes and cost savings. But clinician accountability is only half the equation.
Without patient buy-in, clinicians will never meet these goals. And convincing patients to faithfully use the IT technologies that will help them stay healthy poses a real challenge.
A doctor can hound a diabetic patient to drop pounds, regularly monitor blood glucose, and take his medications, but how much hand-holding does a busy physician have time to provide to keep that patient from suffering complications?
And while there are lots of health IT tools available to help patients adhere to a regimen--tools to refill their meds, remind them about doctor appointments, and nudge them to electronically send their glucose readings to clinicians--the big question is: Will patients bother to use any of those tech-driven tools?
The key to making that happen is patient engagement. Doctors and hospitals--and their health IT vendors--need to get more patients regularly using personal health record (PHR) systems, mobile health monitoring devices, and other tech-driven aids to improve health and wellness in order for patients to be important partners in accountability.
But getting patients on the digital highway has been one of the hardest nuts to crack so far. Case in point: Google Health, a major player in PHRs, failed to attract mass consumer usage of its product, and will be pulling the plug on the service in the coming months.
Sure, there are individuals who love trying out the newest web-based fitness gadgets and apps, tracking their physical activity with mobile devices, and entering their progress into personal health records, such as Google Health. But those people aren't in the majority, nor are they the ones most likely to end up in ER with preventable complications from chronic illnesses.
Unfortunately, the people who can benefit the most from keeping tabs on their health information--and acting on that data--also seem to be among those least inclined to use PHRs and similar IT tools.
Healthcare providers--and health IT vendors--need to recognize that many people are still too unaware, unmotivated--and unfortunately sometimes too sick or too lazy to 1) do what they're supposed to be doing to be healthier in the first place and 2) use electronic tools that are available to help them keep on track with their health.
That means healthcare providers and health IT vendor need to pay special attention to ease-of-use, convenience, and other features that make patients want to use their health IT offerings.
Of course, some players--including Dossia, a consortium of nearly a dozen large employers including Wal-Mart and Intel--have been busy enhancing the user friendliness, including adding social networking and game-like features of their PHR and other health IT offerings. The goal is to encourage more sustained usage of their services by patients and primary caregivers, including moms and adult children.
At our recent InformationWeek Healthcare IT Leadership Forum in New York City, some panelists were convinced that patients crave electronic access to their health information--all of it, including the stuff clinicians often are reluctant to show patients.
But for real healthcare reform to take shape, patients will not only need convenient, real-time electronic access to their sometimes upsetting health information, they'll need to be proactive about using that information to stay healthy. Unfortunately, when clinicians start to feel the pressure to get results under the ACO model, some may simply dismiss patients who don't take responsibility for their health, according to Erica Drazen.
So, wouldn't it be better if more patients at least give health IT a try before that happens? Among health IT products and services that can provide the best potential to help individuals become more responsible for their own health are secure messaging, patient portals, and tele-health applications, including the use of remote monitoring devices or web-based video conferencing, said Drazen.
"ACOs will need to engage patients. You have to go for areas when you can increase participation, like chronic care," she said.
Getting a percentage of the chronically ill more engaged and proactive in their health--especially those individuals who might otherwise tend to be neglectful, forgetful, or unaware about the seriousness of their health issues--is a good start.
But doctors who want to help kick-start healthy behavior among less willing patients also need help identifying those patients. Health IT can be useful there too. Business intelligence and analytic tools can help shed light on populations of patients who are falling through the gaps in their care and outcomes. For example, Southeast Texas Medical Associates (SETMA), a midsized medical practice in Beaumont, Texas, has successfully used IBM Cognos BI tools to analyze patient data in e-health records to identify interruptions in care provided to chronically ill patients of its practice.
SETMA used the analysis tools to compare patients who were not readmitted to those who were, taking into account patient characteristics such as age, gender, ethnicity, follow-up care received, and how soon follow-up care was received once the patient left the hospital. SETMA reduced hospital readmissions by 22% by rolling out special care programs to address the issues of patients who typically fail to go to follow-up appointments or get their prescriptions filled after being discharged from a hospital stay.
"We've got to make it easier for doctors to see who is less engaged" and then follow up with providing tools to help people become more accountable for their own care, she said.
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