The past decade has seen one of the most argumentative and least productive Congresses in the history of our nation – especially when it comes to ideas around healthcare reform. In this arena, the implementation of programs like The Affordable Care Act have become career-defining issues for politicians fighting tooth and nail for its repeal.
However, not every aspect of healthcare has become a dividing political issue. In fact, there has been broad bipartisan support for an aspect of the Precision Medical Initiative known as Meaningful Use. The program is expected to both increase accuracy and organization in patient care in addition to lowering healthcare costs through the implementation of electronic health records (EHR).
… that is, if the transition to EHR is accepted as a tool by both doctors AND patients.
Reactions to electronic medical records have been somewhat mixed for providers, which has significantly challenged the successful execution of strategies for incorporating electronic health records into hospitals and small practices.
Some doctors, like Dr. Jacob Krive of the University of Illinois at Chicago, feel positive about the potential of EHRs. He wrote in reference to EHRs: “Health informatics has a huge potential to once again revolutionize care by providing clinicians with quick and comprehensive access to decision making tools that analyze evidence based knowledge, patient records, and medications databases to produce recommendations and alerts helping more effective on-the-spot decisions leading to further reductions in complications, medical errors, readmissions, mortality, and other measures of quality patient care.”
Alternatively, more than a few physicians have major hesitations about giving up the traditional clipboard and pen in favor of an iPad. For some, the problem lies in an unwillingness to change, but for many more it lies within the inefficiencies of EHR systems, which can cause delays in documentation and high costs.
Of significant interest, however, is that Part 2 of the Meaningful Use plan is now in effect, and its main requirement is making at least 50 percent of health records available electronically to patients in a safe and secure manner within 36 hours of hospital discharge. Part 2 also hopes to ensure that upwards of 5 percent of patients actually do view, download, or transmit this data.
OpenNotes, one EHR program that allows patients a look at their own data, has been working hard to address many of these issues. According to team member John Mafi, the team is looking at few different problems – including whether or not patients are even interested in their own data, as well as how to address the needs of patients with low literacy and how much this new transparency will disrupt doctor workflow.
Concern over patient interest in viewing these documents ranks highly as a concern for most program developers and healthcare providers, as interest is essential for government assistance (ie. money) to continue. Initial studies suggest that over 95 percent of patients think reading their own EHRs would be great way to increase collaboration with their physicians – but only about 30 percent of those patients were likely actually to open and view their files.
OpenNotes is also beginning to deal with the challenges of low literacy, which may require giving patients’ relatives access to certain accounts. Doing this will enable those closest to patients to provide doctors with important information that might not be communicated otherwise and could likely lead to more accurate assessments.
Studies on the issue of patient access have also suggested that patients that enter their own data into their charts tend to have more accurate and comprehensive records. Studies suggest that over 89 percent of the patients who view their own personal records will request changes, whether that means updating recently consolidated information or asking for changes to existing prescriptions.
Unfortunately, all data entered through an online medical portal by patients and their loved ones will likely need to be vetted by a medical professional, which could take substantial time away from patient care. The jury is still out on this aspect; OpenNotes reports suggest that patients that enter their health data before visiting their medical provider can save physicians about five minutes per patient, but those reports are preliminary at best.
Many providers have also expressed a level of concern related to how patients might react to the information provided in their health records. Will they understand everything the doctor has submitted without an explanation? Will they be angry if there are comments or notes in the record that the patient doesn’t consider an issue?
Certainly, we have a ways to go before we can start bragging about an efficient system used by medical professionals nationwide. But as long as these programs maintain government support, it is likely that new strategies and innovations will improve the quality of service offered through these platforms, which will ultimately result in better quality patient care.
Brittni Brown is a recent graduate of The College of Idaho with a degree in environmental studies. Currently, she works for a local marketing company and is in the process of applying to Master's programs in ecological restoration and geographic information systems. She is fascinated by the wide number of applications of GIS and believes the technology can significantly impact society.
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