The Rules And Tools Of Patient Engagement - InformationWeek

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Healthcare // Patient Tools
09:45 AM
Kaveh Safavi
Kaveh Safavi
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The Rules And Tools Of Patient Engagement

Doctors must capitalize on patient curiosity about their own medical records.

For generations, doctors have been saying we want our patients to be more involved in their care, since we know the value engaged patients play in improving outcomes for many preventable illnesses, from heart disease to diabetes. But today, most doctors are not adequately using an available tool to help patients take ownership of their care: the electronic medical record (EMR).

A new Accenture survey shows that the majority of US consumers (84%), armed with their smart phones and home computers, want real access to their electronic medical records. Many individuals (41%) would be willing to switch doctors to have it. But at the same time, just over one-third (36%) say they have full access to their EMR. In contrast, a similar survey of physicians shows the majority (65%) believe patients should only have limited access to their electronic records.

These differing points of view are reminiscent of the time Elaine tried to steal her medical chart on an episode of Seinfeld. Even so, I would argue that patients and doctors can find some common ground.

These trends, as well as other factors, are shifting the role of an EMR system from a mere clinical repository to a platform for shared decision-making between doctors and patients. In this way the process adds transparency and a far more constructive collaboration to the doctor-patient relationship. Increasingly, consumers will seek tools for addressing these two key areas, but they need not exist together to be effective.

Similar to taking charge in other areas of their lives, patients want simple tools such as email and appointment scheduling to help them work with their providers in co-managing their care. The survey shows 70% of consumers believe it’s important to be able to consult their providers via email, but only 36% of patients and doctors are currently able to do so. Similarly, three-quarters of patients (76%) believe it’s important to request prescription refills electronically, yet less than half (48%) have this ability.

For doctors, the challenge is to foster actual commitment around things that actually matter to create better medical outcomes. Like any relationship, if you start with points of common ground, it is easier to develop a path to achieve mutual satisfaction and optimal outcomes.

There are several benefits to making data transparent between the physician and patient: Symptoms are monitored outside doctors’ offices. Patients take accountability for their own personal health by entering and tracking their own data. In fact, more than half of patients (57%) say they are already self-tracking their personal health information, from symptoms to test results. However, in most cases, it’s unlikely that this data is integrated and added to the physician’s electronic record.

Consumers demand transparency from a range of institutions, such as banks, government agencies, and even their employers, and so it is natural that they want and expect the same from their doctors. Importantly, this transparency can build one of the most important aspects in any relationship: trust.

Perhaps Elaine was motivated mostly by curiosity when she tried to view her entire medical record. We know from these survey results that patients want access to their EMR because it will help them get involved in their care via digital means, which in turn allows them to collaborate with their doctors more effectively.

Utilizing the full value of the electronic medical record -- as a tool to involve patients more directly in their care -- offers the promise of greater collaboration, better outcomes and a more fruitful patient-doctor partnership.

Healthcare providers must look beyond Meaningful Use regulations and start asking: Is my site as useful as Amazon? Also in the Patient Engagement issue of InformationWeek Healthcare: IT executives need to stay well informed about the strengths and limitations of comparative effectiveness research. (Free registration required.)

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User Rank: Apprentice
12/6/2013 | 4:20:04 PM
Tools out there to help collect medical records
I think you nailed it - patients need ways to help stay engaged in their own health. One way to do this is allow them to control their own medical records and even have some structured data points in place to review prescription instructions, weight data collection during recent visits, etc.


Personally - I was tasked with collecting medical records for my family. As I was hatching out the plan to do so, I kept on reading about how much of a hassle it is to collect them.


So in keeping with the theme (tools), I wanted to share that I found and am using a service called Zweena Health. They went out, collected all of my records, and plugged them into a platform so I can view them digitally (or as standard scanned PDFs).


It's definitely true: once I've had this in place, had access to my and my family's records, we've been much more health conscious: eating better, knowing that we need to schedule yearly physicals for my daughters, etc.
User Rank: Ninja
12/6/2013 | 3:05:48 PM
Re: Replacing the doctor visit
I get my medical care from Beth Israel in Boston, and they have a very advanced medical record system in place where the docs communicate with each other, and a subset of the notes are available to me.One great thing this type of system accomplishes is the elimination of a lot of telephone tag - I get an email telling me the results of a test are available, so I don't have to waste time chasing after the doc or his/her assistant for results.
This is especially valuable if the result is about what we were expecting, and I'm to be instructed that I don't need anything more, or if I have to pick up a prescription. The doctor and I save time, the insurance company saves money, and the world is a happier place. If it's really bad news, I'm assuming it won't be online, they'd want to tell me in a more appropriate setting.

User Rank: Author
12/6/2013 | 10:48:51 AM
Replacing the doctor visit
How many tasks at your job do you now handle by a quick instant message that used to require a phone call or face-to-face discussion? How many meetings have been replaced by just posting information to a website where people can grab the status updates they need as they need them? That kind of massive productivity gain hasn't come to healthcare -- some things are better for everyone done digitally through this kind of online info sharing, even while the face-to-face meetings will remain indispensible for some situations. But the system still is set up for docs to get paid only to see people.
David F. Carr
David F. Carr,
User Rank: Author
12/6/2013 | 10:43:01 AM
Honest assessments
Do you have any concern about doctors feeling they can't be as frank and honest in notes that might be seen by patients? That is, as opposed to notes for only their own use and that of other doctors. What about the case where recording the fact that "this patient is delusional" is an important piece of information to share with other docs, but a troublesome data point for a patient to see about themselves.
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