Health Information Technology – Medical Practice Management, Health Information Technology

Patient EHR access leads to real engagement, improved care

October 13, 2012 By Robert Green Leave a Comment

This is an excerpt from a guest post that I recently shared with EHR Intelligence. There is an incredible convergence of people and technology within the community of healthcare that is developing right now. It is one that represents such an important new interaction among the entire clinic staff, patient and other caregivers. In fact, it is that the challenge of defining this new patient experience that is also the opportunity for some immediate wins in both improved patient care and clinic reputation.

Defining the patient experience remains a difficult conversation for leaders in clinics around the country. What this experience represents is obscurity in the context of what it means both in person and in the virtual setting of social media. While the discussion of electronic protected health information (ePHI) has already progressed to the level of how to facilitate sophisticated sharing, the nature of the interaction between people and these data remains a challenge.

The recent OpenNotes Oct. 11 public meeting reflected a need for a culture change with regard to physicians sharing a view of the electronic health record (EHR) notes screen during the patient visit. What’s new is the participatory environment wherein those physician notes in the medical record are visible to the patient while they are created during the encounter. Read more here: http://ehrintelligence.com/2012/10/12/patient-ehr-access-leads-to-real-engagement-improved-care/

Filed Under: EHR, Health Information Technology, Patient Engagement

Health Information Technology and Human Interaction Throughout

August 31, 2012 By Robert Green Leave a Comment

As we continue to use new ways to engage people with Health Information Technology (HIT) through the increased volume and frequency of information, it is more important than ever to recognize the core value of human interactions. Healthcare is personal because its not just about an acute or chronic condition, its about a human life. So as the patient experience expands into the virtual world of electronic information and interactions, it has never been more important to talk about a fully engaged staff in the clinic as much as the engaged patient. Whether its the patient accessing their electronic health information or participating more actively in their health with some type of mobile application on their smartphone, the need for guidance and support between the people in the clinic and the patient is the real patient engagement in this whole discussion. First, because healthcare is not just a physical experience, but an emotional one as well. Second, because managing one’s health is more than just managing a condition and health data, but a life. Finally, because there are many lives involved here in this community of healthcare (that includes those people in the clinic) and every one of them represent personal experiences that are important and so many meaningful connections.

I invite you to read more on my guest blog post here:

http://ehrintelligence.com/2012/08/30/health-it-should-reinforce-the-personal-nature-of-care/

Filed Under: Health Information Technology, Patient Engagement, Patient Experience

Health Data and the Junk Drawer

June 13, 2012 By Robert Green Leave a Comment

I can remember conversations that I had with physicians several years ago when their favorite benefit of the EMR software was the ‘readability’ of the electronic charts. They had finally put in the past the days when each one of the physicians in the clinic would struggle to read the handwriting of another. So while one physician filling in for another on a given day was still a busy day – at least that variable of trying to decode handwriting in the patient’s chart was gone. Now that all of that patient data has been accumulated within the clinic, the conversation has evolved to the accessibility of that data to the patient. Whether its a genuine interest in participating or managing one’s own health or compiling a personal health record (PHR) or seeking transparency in that clinical documentation process or extending the patient experience with mHealth, one thing is true: it’s going to be messy. This whole scenario reminded me of the ‘junk drawer’ in the kitchen. I’m not sure where the term junk drawer originated, and I don’t even consider the stuff in that drawer junk. But what I do know is that no matter how many times in my life as a child and adult either I or someone else organizes that drawer, it always seems a bit messy to me. One of the reasons for this apparent messiness may be that there is such a variety of stuff in there. It’s interesting how many items that lie next to each other have nothing in common except their presence in that drawer.

An interesting dichotomy has developed from the time of physicians and patients wanting that readability of charts for the benefit of flexibility and continuity of care for patients of the clinic to one of disappointment with that same idea because the next appointment for the patient may not be with the clinician who provided care today. The team approach does provide real value in terms of both the in-person clinic visit for the patient and will be very important in the evolution of mHealth and healthcare social media. However, there is also real value in that individual level of trust that a patient develops with a particular clinician. Data is good, but its even better with guidance. There’s no reason to turn back now, just ask those people who as patients want access to their health information and to participate in their care. As much as we may like to put labels on everything for the purpose of neat and tidy organization, the reality is that just like the stuff in that junk drawer the use of mHealth and healthcare social media is going to seem a bit messy. One thing is true: the more people who have access to that junk drawer will only further assure it’s going to be complicated (and it’s not really junk in there).

Filed Under: Coordination of Care, Health Information Technology, Healthcare Social Media, Patient Experience

At Your Service – The Doctor Is In

May 22, 2012 By Robert Green Leave a Comment

The boundaries of the patient experience continues to expand in the dialogue about patient care with the inclusion of such topics as social media (SoMe) and access to electronic personal health information (ePHI). Of course, one important thing to keep in mind is that this dialogue is lively because of people on both sides of the patient’s care (patients and providers) who enjoy using SoMe tools and participating in these communities. To be fair, and transparent, I too participate and enjoy sharing thoughts and communicating with people in social media platforms. It really is incredible how easy it is to engage in meaningful conversations with people in these virtual communities. Further, the accessibility for patients’ own ePHI from those clinic encounters affords a personal collection of data and perhaps even some more ownership of their own health.

I know and work with physicians who are highly engaged in SoMe and are excited about connecting with their patients for purposes such as education and even live group interactions. I also know other physicians who, to put it mildly, are taking more of a ‘wait and see’ approach to this virtual world. One of the reasons for this resistance is the fact that SoMe communities are always ‘on’ and participation is a real ongoing commitment. Regardless of physicians’ participation in the SoMe communities one thing certainly remains true – physicians provide guidance to their patients about their health in a variety of circumstances. What I also know is that it is unreasonable to assume that patients having a 24/7 direct line to a particular physician is going to make life better for either person in this scenario. One more thing will remain true in patient care, and that is the physician is not the only person in the clinic who engages in the patient experience. Further, as compelling as the virtual world may be in the SoMe communities, sometimes a patient just has be come into the clinic for the appropriate care and guidance.

Just a thought, but from many of the comments that patients have shared with me about their dissatisfaction with the clinic experience it did not include the physician’s use of SoMe. Instead, it was that the lack of communication between the clerical staff in the clinic and the physician on behalf of the patient was just puzzling. So in these cases isn’t it less about ‘SoMe’ and more ‘So much more on behalf of the patient with a fully engaged clinic staff beyond just the physician?’ For more information about what patients want from their experience in your clinic – just ask them. Better yet, do it before they use SoMe to post a less than favorable review after their clinic experience is history!

Filed Under: Health Information Technology, Healthcare Social Media, Patient Experience, Patient Satisfaction

Physician Strives to Help During Infamous Paper Chase

May 11, 2012 By Robert Green Leave a Comment

There is a compelling center of care that I believe deserves some attention – and this one places the physician in that position. While patient-centered care is clearly a critical discussion that must continue to evolve across the continuum, there is another important subject of physician burnout. The nature of this feeling for a physician is a personal one, and I have no intention of offering any sort of general prescription for this condition. However, I would like to share a conversation that I had with a physician a few months ago that may offer some inspiration. As a physician in an immediate care clinic, he had grown familiar with that feeling of being in the middle of providing meaningful care for each patient and sustaining production for the management team. I stopped by the clinic around lunchtime to see how things were going. His door was ajar and he was working on his PC, so I knocked just to get his attention. He spun around in his chair with a smile on his face and welcomed me into his office, offering me a chair. The topic of the production environment for him was not a new one, but this time it was exacerbated by the recent termination of the EMR vendor relationship with the clinic a few weeks earlier. So here he was, back at the center of the infamous paper chase with patient care and the complete encounter documentation process. He was composing an evidence-based algorithm using the Microsoft Notepad application on his PC. His intention with this effort being to install and run a medical decision support system to share best practices with third world countries. While this is an ongoing process for him, my point in sharing this story is to highlight a genuine effort within a less than ideal environment. From my experiences with physicians as friends and clients and even providers of my care, one thing remains true: Physicians are not just doing a job as a physician, they are living a life as one. The best developments in medical care will not come from regulations, but from physicians within clinics. While there is good reason to be aware of the dialogue regarding regulations and other requirements in the healthcare industry, let’s not forget who really has the influence to improve medical care in the clinic everyday.

Do you have an inspiring story to share about a physician you know?

Filed Under: Health Information Technology, Patient Experience

HIPAA

April 26, 2012 By Robert Green Leave a Comment

Health Insurance Portability and Accountability Act. In the spirit of getting back to the basics, a brief reminder of that the one and only “P” in HIPAA represents portability. With the running ‘carrot and the stick’ dialogue about “meaningful use” of EMR and the incentives for its demonstration within the clinic, lets not forget the portability not only of the information but of the patients as well. This portability must mean something to everyone in the clinic every day with every patient. In spite of the hype associated with chasing the “meaningful use” incentive, HIPAA is not just an IT issue with regard to privacy and security of personal health information.

Filed Under: Health Information Technology, Healthcare Industry, Patient Satisfaction

Why do people choose us?

April 17, 2012 By Robert Green Leave a Comment

Is it because the physician’s are members of an independent physicians’ association?

Maybe it’s because of our friendly staff?

Were we the first clinic that they could find when they needed the guidance and care that we provide?

Was it because of the reputation of a particular physician?

Did we respond in a certain way?

It may all matter, and it’s just the beginning of the list. One thing is true about patient engagement – it can happen to anyone in the clinic. Ready or not!

Filed Under: Clinic Awareness, Health Information Technology

The fulfillment process

April 9, 2012 By Robert Green Leave a Comment

The expectations for quality of care among patients clearly include their experiences beyond the time with the physician. Combine these individual expectations with the new minimum requirements for electronic personal health information and electronic medical records performance and the concept of advocate in the clinic takes on a critical new importance. Physicians and their staff who have made the shared commitment for patient care are already making important progress in solidifying their value in the community. Those physicians and staff who disregard the importance and value of consistency and communication throughout the entire patient experience will earn a reputation of mediocrity in their community.

Filed Under: Clinic Awareness, Coordination of Care, Health Information Technology

The Patient Experience

March 28, 2012 By Robert Green Leave a Comment

A great aspect of the EMR “meaningful use” guidelines from the Centers for Medicare and Medicaid (CMS) is the wide acceptance across private health insurance providers establishing a new minimum for the structure of medical records for purposes that range from measuring clinical outcomes to sharing this information within the continuum of care. It is interesting though, how much this conversation in the clinic too often does not involve the patient experience.

In fact, for some physicians I’ve met over the past couple years in this ‘stimulus environment’ for the implementation and use of EMR a contraindication exists within their clinic. It involves a perceived catastrophic outcome of including a discussion of the patient experience within the context of the strategic use of EMR within the clinic. This has always been a conversation about people and in this highly competitive industry where attracting and retaining the attention of patients for both better health outcomes and sustainability of the clinic with loyal customers its really time to stop focusing on the carrot from the federal government. There has never been a better time to offer the patient the carrot of better clinical outcomes and customer service.

Filed Under: Coordination of Care, Health Information Technology