The Rules And Tools Of Patient Engagement

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.

Collaboration
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.

Transparency
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.)