Patients as partners in health IT

By Sheryl Cash, amednews correspondent. Posted Jan. 30, 2012

Like many practices, Women’s Wellness Place is continually upgrading its technology to better serve and empower providers and patients.

This practice has used an electronic medical record system for eight years and recently implemented e-prescribing; a website with comprehensive patient information; and a portal where patients can update their medical history and contact information and request prescription refills.

Despite the cost and initial sacrifices associated with EMR and other technologies, “we’re not done yet,” said Kristen Kratzert, MD, a partner in the three-physician obstetrics and gynecology practice in Syracuse, N.Y. She said Women’s Wellness Place plans to implement a knowledge-based system to aid in patient management and diagnostics and online scheduling in the near future.

“We’re always trying to make our practice better and more efficient,” Dr. Kratzert said.

Practices such as Women’s Wellness Place are investing in the technologies that involve helping the patient make his or her own experience more efficient — and, as a result, helping the physician make the practice more efficient.

“It’s a really exciting time in health care,” said Deanna R. Willis, MD, a family physician in Indianapolis, associate professor at Indiana University and chief medical officer of quality and medical management for the 200-physician Indiana University Medical Group Primary Care. “I think if we look at the banking industry over the past 10 or 15 years, and the way they have automated with ATMs and online account management, we’re about to take a similar leap forward in health care.

“Eliminating unnecessary waste from the processes that support the [doctor visit] helps the patient feel like their time is valued,” Dr. Willis said, especially when patients believe the real value of a visit “is the person-to-person interaction with the doctor.”

New communication tools
Patient portals, for example, allow both patients and physicians to communicate over a secure website to share test results, schedule and cancel appointments, make online payments, and review or add prescription and other patient information.

“A portal can provide a [Health Insurance Portability and Accountability Act] – compliant and secure way to communicate with a patient,” Dr. Willis said. “If a patient reviews their medication list and health history before they go into the office, it will be more accurate, safer and more efficient for the office team.”

Through in-office patient kiosks and tablet computers, patients also can update health and insurance information and consent documentation before they see the doctor. With education materials – provided online or at an in-office work station – patients view information relevant to their condition and age and in their primary language.

In addition, some practices are using online coaches to help patients improve their diet or manage a chronic condition.

“A coach can touch more people in a Web environment than face to face,” Dr. Willis said. “Online coaching also can reduce emergency department visits and hospitalizations and effectively change outcomes. This will be particularly important for practices working to adopt patient-centered medical home formats.”

For many doctors, the challenge is if they have the time or money to implement these technologies. Fortunately, many are offered through a physician’s existing EMR software.

Thirty-four percent of all U.S. physicians and 39% of all primary care physicians had EMR technology in 2011, according to the Centers for Disease Control and Prevention. Yet most of these practices are not implementing the expanded communication tools that their systems provide, such as portal services for making appointments, said Rosemarie Nelson, a Syracuse, N.Y.-based principal with the Medical Group Management Assn. health care consulting group.

Electronic scheduling, prescription management and patient portals often are available, or can be added to an EMR system, for a nominal fee.

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