Rhapsody Health Solutions Team

IT is the Patient (or E-Patient or Citizen)

blue button image

If you haven’t noticed, there is a mad dash to get IT initiatives underway to meet the Meaningful Use requirements.

Within just the last few months, hospitals and other healthcare organizations have invested endless hours participating in discussions, meetings and forums to discuss their respective plans on how to meet the Meaningful Use requirements. As a result of satisfying them, these organizations will be able to enhance patient care, reduce medical errors and, ultimately, improve the quality and efficiency of the healthcare industry as a whole.

The enthusiasm by these organizations is stimulating! This reminds me – the other part of the equation is incentive payments, which will be accessible in 2011.

This enthusiasm is still all about the patient, right?

David Blumenthal, MD, MPP, the National Coordinator for Health Information Technology (ONC), stated in April 2010:

“What I’m confident of is that every element in the meaningful use matrix has a direct link to the health of patients, the health of populations or the efficiency of our health care system. If there’s any element in that matrix that doesn’t have that link, it doesn’t belong there.”

Okay, it sounds like it is about the patient.

What is really innovative though, and truly centered on the patient, is what the Markle Foundation called for – a big blue button for people to get their own health information.

According to Carol Diamond, MD, MPH, managing director at Markle:

“By clicking the blue button, you could get your own health information electronically—things like summaries of doctor visits, medications you are currently taking, or test results. Being able to have your own electronic copies and share them as you need to with your doctors is a first step in truly enabling people to engage in their health care.”

“This capability is not common today, but we have the opportunity to make it a basic expectation—especially now that billions of public dollars will be flowing to help subsidize health information technology.”

Simple, patent-centered, innovative – it sounds ideal! Wait…“patient-centered” isn’t right. “E-patient-centered” is better. Wait… that’s too limiting and it may quickly become outdated. Citizen-centered! That sounds generically perfect!

A little humor (very little), but there is a discussion about what to term this new empowered patient. To engage in the discussion, read the following three articles and blog posts:

  1. More ‘Empowered’ Patients Question Doctors’ Orders (USA Today, September 1, 2010)
  2. Citizen Patient: Empowered and Unempowered (Health Is Social, September 1, 2010)

The bottom line from these articles is that more and more patients want their information electronically and want to have empowered discussions with their physicians about their health. Let’s make it personal – Having timely access to our health information should be the norm, not the exception, to how we manage our well-being.

Coming full circle to the big blue button, timely, electronic access is what is needed, but it begs the question – what comes first the EHR or the PHR?

The reality is there has to be a way to get the information from the physician to the patient.

Electronic communication is the best way, and this means more than an email. It means delivering the data in a format which can be imported or read into the patient’s PHR. Unless there is a Mint for healthcare records, this would be the most practical way to do it.

Wait a minute, what is Mint? It is a great, innovative program which just sucks in your personal financial data from multiple sources, consolidates it, and presents a view to a citizen. You gain a complete view of your personal financial condition and budget in one web-based portal view with data coming from multiple financial institutions.

Why can’t we do this for healthcare? This sounds like the ideal blue button!

It would be, but there has to be some system in which to get the data from, just like Mint gathers information from various financial institutions’ systems and then presents the information. In healthcare, the most likely system from which to get data is your electronic health or medical record. For this to happen, the following elements need to be in place:

  • An electronic source system at each healthcare provider (e.g., hospital, physician, etc.) you visit
  • Each source system needs to record information about the care your received (e.g., diagnosis, test results, etc.)
  • The source system needs to have the ability to communicate – electronically and securely – your information to your designated system (e.g., PHR or similar system)

So, the EHR needs to come first. There needs be a means – an electronic source system – which can communicate to your end – a PHR.

As stated earlier, innovative thoughts and practices are happening in healthcare as well as other industries. We need to learn from both and apply where appropriate.

The blue button to gain access to your personal health information keeps all of the Meaningful Use initiatives in perspective, meaning keeping it focused on us – the patient or citizen. Unfortunately, the danger is losing sight of this focus and implementing systems for the sake of implementing something to gain the incentives. The connection to the patient must be paramount.

The mad dash to implementing IT systems is happening.  Let’s ensure the focus stays on the patient and how to empower us to be better patients and citizens in managing our health.

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