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E-Patient Update:  Is Technology Getting Ahead Of Medical Privacy?

Posted on December 9, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I don’t know about y’all, but I love, love, love interacting with Google’s AI on my smartphone. It’s beyond convenient – it seems to simply read my mind and dish out exactly the content I needed.

That could have unwelcome implications, however, when you bear in mind that Google might be recording your question. Specifically, for a few years now, Google’s AI has apparently been recording users’ conversations whenever it is triggered. While Google makes no secret of the matter, and apparently provides directions on how to erase these recordings, it doesn’t affirmatively ask for your consent either — at least not in any terribly conspicuous way — though it might have buried the request in a block of legal language.

Now, everybody has a different tolerance for risk, and mine is fairly high. So unless an entity does something to suggest to me that it’s a cybercrook, I’m not likely to lose any sleep over the information it has harvested from my conversations. In my way of looking at the world, the odds that gathering such information will harm me are low, while the odds collection will help me are much greater. But I know that others feel much differently than myself.

For these reasons, I think it’s time to stop and take a look at whether we should regulate potential medical conversations with intermediaries like Google, whether or not they have a direct stake in the healthcare world. As this example illustrates, just because they’re neither providers, payers or business associates doesn’t mean they don’t manage highly sensitive healthcare information.

In thinking this over, my first reaction is to throw my hands in the air and give up. After all, how can we possibly track or regulate the flow of medical information falls outside the bounds of HIPAA or state privacy laws? How do we decide what behavior might constitute an egregious leak of medical information, and what could be seen as a mild mistake, given that the rules around provider and associate behavior may not apply? This is certainly a challenging problem.

But the more I consider these issues, the more I am convinced that we could at least develop some guidelines for handling of medical information by non-medical third parties, including what type of consumer disclosures are required when collecting data that might include healthcare information, what steps the intermediary takes to protect the data and how to opt out of data collection.

Given how complex these issues are, it’s unlikely we would succeed at regulating them effectively the first time, or even the fourth or fifth. And realistically, I doubt we can successfully apply the same standards to non-medical entities fielding health questions as we can to providers or business associates. That being said, I think we should pay more attention to such issues. They are likely to become more important, not less, as time goes by.

What Should Coffee Shops and Healthcare Organizations Have in Common?

Posted on December 8, 2016 I Written By

The following is a guest blog post by Sarah Bennight, Marketing Strategist of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter:@StericycleComms
sarah-bennight
Several months ago, I failed to get up in time for my normal coffee brew. So on the way to work, I decided to stop at a local Starbucks to grab a latte. The drive-thru was packed. Panicking, I stepped inside where the line was sure to be shorter. It was not. As I waited, I noticed folks walking in and going straight to the barista bar, giving an order, and receiving it immediately. No line. No wait. What was this amazing service and why didn’t I receive it? I felt left out of cool kids club as I waited my turn and finally arrived 3 minutes late to work. After searching my junk email, I found several emails touting a new order in app and pay service. With my busy lifestyle and love of coffee, I thought this was too good to be true.

Next time I was running late, I opened the app and ordered my favorite beverage with one hand while putting on makeup with the other. I felt like a true VIP when I sauntered into my local cafe and whispered my order to the barista, who had my drink ready and waiting. You can bet, if I need a coffee on a hurried morning, I will remain loyal to the pre-order app from Starbucks. It’s just too easy.

With increasingly busy lifestyles and the need to complete more in less time, consumers look for the quickest and easiest goods and services. We are much more willing to adventure into unknown spaces if it promises to give us precious time back. After moving last month, I received a card in the mail from a well-known grocer saying “welcome to the neighborhood, we now offer online grocery shopping.” Busy people in my neighborhood are celebrating an end to their most hated and time-consuming weekly errand. I have yet to try this service since there are rarely timeslots open, but the Starbucks’ model of order online and avoid the wait is becoming the norm.

We are so accustomed to immediate service that we sometimes get frustrated with even small delays. Take, for example, my two very different experiences at urgent care centers. Earlier this year, I had to take my daughter in for possible strep throat. I avoided the trip long enough that her primary care physician office was closed and urgent care was the only option. We took our chances with the local pediatric urgent care and waited for our sick child to be seen for over two hours – 45 minutes of which was spent in the examination room before anyone came in to see us.

When the need arose for me to visit an urgent care clinic recently, I was already well versed in the advantages of ordering online without a wait. Although I had been to the local ER for the same condition and they had all of my labs and records, the thought of a potentially lengthy wait was daunting. So, I searched for a clinic that could accommodate my schedule and decided to try a new clinic because they offered the “online ordering model” for urgent care visits. I signed up online and was called back within 10 minutes of arriving at the clinic. The doctor saw me within 15 minutes of being placed in a room. The experience was so positive the clinic has earned my loyalty for future care needs. Not only do they have a caring staff, they get me in and out in a reasonable time.

This trend is rapidly being adopted across commercial industries, but healthcare isn’t far behind. And health providers that aren’t ready to adapt will soon feel the pressure as consumers demand convenience. Services and tools such as Amazon PrimeNow and Disneyland FastPasses prove one thing: Americans simply hate to wait.

Recently, I spoke with a client who made the decision to implement our online scheduling solution as a result of increasingly consumer-driven expectations. Competition with retail clinics for primary care visits also played a role in their decision. They stated, “We are now competing with Walgreens and CVS for simple clinic visits because we make it too difficult to get the patient in the door.” A McKinsey 2015 Consumer Health Insights Survey found the same, as two thirds of the people surveyed reported they would be comfortable using retail clinics such as CVS or Walgreens for care. When asked why, the major reason cited was accessibility.

With two very different clinic visits shaping my view, I imagine on demand access and appointment scheduling will continue to shape the healthcare access scene in the next few years. Convenience is king in our consumer-minded world, and those who rely on only traditional methods of getting patients in the door could miss potential opportunities – or worse, lose existing patients to competitors who provide easier access. I won’t return to the first urgent care clinic because the more recent visit offered better access and a more convenient experience by significantly cutting my wait time. With my new found love for ordering online and avoiding the wait, I have also recently changed the family eye doctor to one who offers this service. Now, if they could only offer an onsite coffee bar…

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality call center & telephone answering servicespatient access services and automated communication technology. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

Are Providers Using Effective Patient Communication Methods?

Posted on December 1, 2016 I Written By

The following is a guest blog post by Cristina Dafonte, Marketing Associate of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter:@StericycleComms
cristina-dafonte
This year at MGMA 2016, the Stericycle Communication Solutions team had the opportunity to survey over 800 providers about their patient communication strategy. Getting to collect our own data, rather than relying on facts and figures from scholarly articles, was truly invaluable. But what was even more exciting was sitting down and analyzing the results.

Many of the statistics weren’t surprising – nearly 100% of providers are sending appointment reminders, 60% of providers are using technology to send these reminders, and 2/3 of providers surveyed love the idea of online self-scheduling. These statistics all made sense to me… it’s almost 2017, of course providers would prefer to use technology when it comes to their patient communications.

But as I dug more into the numbers, I saw a startling trend:

  • Only 1 out of 3 providers who “love” online self-scheduling offer it to their patients
  • While almost all providers are sending appointment reminders, 1/3 are still manually calling their patients
  • Over 60% of providers are only sending appointment reminders via ONE modality

I started to think about other parts of my life where I booked appointments or used technology to interact with a vendor– did these healthcare numbers match their non-healthcare counterparts?

First I looked to my hair salon. When I go to their website, I have the ability to book an appointment with my current hair dresser directly on their home screen. I get an email reminder the day that I book the appointment with a calendar attachment. The day before the appointment, I get a text reminding me what time my appointment is and whom it is with. Four months after the appointment, I get an email reminding me that it’s time to come in for my next appointment… with a link to book an appointment online. Surprisingly, this didn’t match what I was seeing in my survey data analysis. When I looked at scheduling an appointment to get my car serviced, I saw the same trend – booking was conveniently online, the communications were all automated, and I received more than one reminder.

So why does there seem to be such a difference when it comes to healthcare communication? Our survey shows that providers like the idea of technology, so, I wonder, why are most providers only going halfway? What is it that is holding them back from fully investing in automated patient communications? According to TIME, the average person looks at his or her phone 46 times per day. As we near 2017, shouldn’t we reach and capture patients where they are engaged and spend most of their time – on their mobile devices and computers?

For more MGMA survey results and a sneak peak into how Stericycle Communication Solutions can help you adopt an automated patient communication strategy, download the infographic here.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality call center & telephone answering servicespatient access services and automated communication technology. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

Ignoring the Obvious: Major Health IT Organizations Put Aside Patients

Posted on November 18, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Frustrated stories from patients as well as health care providers repeatedly underline the importance of making a seismic shift in the storage and control of patient data. The current system leads to inaccessible records, patients who reach nursing homes or other treatment centers without information crucial to their care, excess radiation from repeated tests, massive data breaches that compromise thousands of patients at a time, and–most notably for quality–patients excluded from planning their own care.

A simple solution became available over the past 25 years with the widespread adoption of the Web, and has been rendered even easier by modern Software as a Service (SaaS): storing the entire record over the patient’s lifetime with the patient. This was unfeasible in the age of patient records, but is currently efficient, secure, and easy to manage. The only reason we didn’t switch to personal records years ago is the greed and bad faith of the health care institutions: keeping hold of the data allows them to exploit it in order to market treatments to patients that they don’t need, while hampering the ability of other institutions to recruit and treat patients.

So I wonder how the American Health Information Management Association (AHIMA) can’t feel ridiculous, if not a bit seamy, by releasing a 3000-word report on the patient data crisis this past October without even a hint at the solution. On the contrary: using words designed to protect the privileges of the health care provider, they call this crisis a “patient matching” problem. The very terminology sets in stone the current practice of scattering health records among providers, with the assumption that selective records will be recombined for particular treatment purposes–if those records can be found.

A reading of their report reveals that the crisis outpaces the tepid remedies suggested by conventional institutions. In a survey, institutions admitted that up to eight percent of their patients have duplicate records in the institutions own systems (six percent of the survey respondents reported this high figure). Institutions also report spending large efforts on mitigating the problems of duplicate records: 47 percent do so during patient registration, and 72 percent run efforts on a weekly basis. AHIMA didn’t even ask about the problems caused by lack of access to records from other providers.

To pretend they are addressing the problem without actually offering the solution, AHIMA issues some rather bizarre recommendations. Along with extending the same processes currently in use, they suggest using biometrics such as fingerprints or retinal scans. This has a worrisome impact on patient privacy–it puts out more and more information that is indelibly linked to persons and that can be used to track those persons. What are the implications of such recommendations in the current environment, which features not only targeted system intrusions by international criminal organizations, but the unaccountable transfer of data by those authorized to collect it? We should strenuously oppose the collection of unnecessary personal information. But it makes sense for a professional organization to seek a solution that leads to the installation of more equipment, requires more specialized staff, tightens their control over individuals, and raises health care costs.

There’s nothing wrong with certain modest suggestions in the AHIMA report. Standardizing the registration process and following the basic information practices they recommend (compliance with regulations, etc.) should be in place at any professional institution. But none of that will bring together the records doctors and other health care professionals need to deliver care.

Years ago, Microsoft HealthVault and Google Health tried to bring patient control into the mainstream. Neither caught on, because the time was not right. A major barrier to adoption was resistance by health care providers, who (together with the vendors of their electronic health records) disallowed patients from downloading provider data. The Department of Veterans Affairs Blue Button won fans in both the veterans’ community and a few other institutions (for instance, Kaiser Permanente supported it) but turned out to be an imperfect standard and was never integrated into a true patient-centered health system.

But cracks in the current system are appearing as health care providers are shoved toward fee-for-value systems. Technologies are also coalescing around personal records. Notably, the open source HIE of One project, described in another article, employs standard security and authentication protocols to give patients control over what data gets sent out and who receives it.

Patient control, not patient “matching,” is the future of health care. The patient will ensure that her doctors and any legitimate researchers get access to data. Certainly, there are serious issues left, such as data management for patients who have trouble with the technical side of the storage systems, and informed consent protocols that give researchers maximum opportunities for deriving beneficial insights from patient data. But the current system isn’t working for doctors or researchers any better than it is for patients. A strong personal health record system will advance us in all areas of health care.

E-Patient Update: The Patient Data Engagement Leader

Posted on October 20, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As healthcare delivery models shift responsibility for patient health to the patients themselves, it’s becoming more important to give them tools to help them get and stay healthy. Increasingly, digital health tools are filling the bill.

For example, portals are moving from largely billing and scheduling apps to exchanging of patient data, holding two-way conversations between patient and doctor and even tracking key indicators like blood glucose levels. Wearables are slowly becoming capable of helping doctors improve diagnoses, and patterns revealed by big data should soon be used to create personalized treatment plants.

The ultimate goal of all this, of course, is to push as much data power as possible into the hands of consumers. After all, for patients to be engaged with their health, it helps to make them feel in control, and the more sophisticated information they get, the better choices they can make. Or at least that’s how the traditional script reads.

Now, as an e-patient, the above is certainly true for me. Every incremental improvement in the data I get me brings me closer to taking on otherwise overwhelming health challenges. That’s true, in part, because I’m comfortable reading charts, extrapolating conclusions from data points and visualizing ways to make use of the information. But if you want less tech-friendly patients to get on board, they’re going to need help.

The patient engagement leader

And where will that help come from? I’d argue that hospitals and clinics need to create a new position dedicated to helping engage patients, including though not limited to helping them make their health data their own. This position would cut across several disciplines, ranging from patient health education clinical medicine to data analytics.

The person owning this position would need to be current in patient engagement goals across the population and by disease/condition type, understand the preferred usage patterns established by the hospital, ACO, delivery network or clinic and understand trends in health behavior well enough to help steer patients in the right direction.

It also wouldn’t hurt if such a person had a healthy dose of marketing skills under their belt, as part of the patient engagement process is simply selling consumers on the idea that they can and should take more responsibility for their health outcomes. Speaking from personal experience, a good marketer can wheedle, nudge and empower people by turns, and this will be very necessary to boost your engagement.

While this could be a middle management position, it would at least need to have the full support of the C-suite. After all, you can’t promote population-wide improvements in health by nibbling around the edges of the problem. Such measures need to be comprehensive and strategic to the mission of the healthcare organization as a whole, and the person behind the needs to have the authority to see them through.

Patients in control

If things go right, establishing this position would lead to the creation of a better-educated, more-confident patient population with a greater sense of self efficacy regarding their health. While specific goals would vary from one healthcare organization to the other, such an initiative would ideally lead to improvements in key metrics such as A1c levels population-wide, drops in hospital admission and readmission rates and simultaneously, lower spending on more intense modes of care.

Not only that, you could very well see patient satisfaction increase as well. After all, patients may not feel capable of making important health changes on their own, and if you help them do that it stands to reason that they’ll appreciate it.

Ultimately, engaging patients with their health calls for participation by everyone who touches the patient, from techs to the physician, nurses to the billing department. But if you put a patient engagement officer in place, it’s more likely that these efforts will have a focus.

Patients Want the Ultimate Experience – Convenient, Considerate, and Compassionate

Posted on October 13, 2016 I Written By

The following is a guest blog post by Chelsea Kimbrough, a copywriter for Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Chelsea Kimbrough
For many patients – myself included – braving the doctor’s office can be a difficult, scary task. So, when I moved to a new state, I put off finding a new healthcare clinic. My procrastination recently turned to panic when the time for an annual wellness check arrived.

After researching local providers, reading countless patient reviews, and cross-examining healthcare capabilities, I hesitantly scheduled an appointment. When the appointment finally passed, I was surprised to not only enjoy the experience, but to confidently schedule another. Here’s why:

  1. They offered patient-friendly online self-scheduling. With a majority of my weekdays absorbed by work, I had little opportunity to make phone calls. But with the option of online self-scheduling, I was able to schedule an appointment at a time and in a way that worked best for me.
  2. They ensured I was aware of and prepared for my upcoming appointment. I received a text message prompting my appointment confirmation and an email outlining what I needed for the appointment. Both these nontraditional communications supported my appointment’s success.
  3. My wait time was minimal. From the moment I arrived, I was met with friendly, courteous support. And before leaving the facility, I was able to quickly schedule a follow-up appointment – all of which minimally impacted the remainder of my day.
  4. I received one-on-one, thoughtful attention and service. And for a nervous patient, this was the difference between loyalty and abandonment.
  5. I was able to provide feedback about my experience. Though my feedback was primarily positive, I appreciated that my opinions and experience were valued.

Though online reviews helped me make my initial decision to schedule an appointment, the entire experience is what put my nervousness at ease. From an online self-scheduling option to a post-appointment survey, this organization’s patient-focused approach was both a novel and welcome experience, and is what will ensure I continue trusting my health in their care for years to come.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services. Connect with Stericycle Communication Solutions on social media: @StericycleComms

Engaging Patients With Health Data Cuts Louisiana ED Overuse

Posted on September 15, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Maybe I’m misreading things, but it seems to me that few health IT pros really believe we can get patients to leverage their own health data successfully. And I understand why. After all, we don’t even have clear evidence that patient portals improve outcomes, and portals are probably the most successful engagement tool the industry has come up with to date.

And not to be a jerk about it, but I bet you’d be hard-pressed to find HIT gurus who believed the state of Louisiana would lead the way, as the achingly poor southern state isn’t exactly known for being a healthcare thought leader.  As it so happens, though, the state has actually succeeded where highfalutin’ health systems have failed.

Over one year, the state has managed to generate a 23% increase in health IT use among at-risk patients, and also, a 10.2% decrease in non-emergent use of emergency departments by Medicaid managed care organization members, thank you very much.

So how did Louisiana’s top healthcare brass accomplish this feat? Among other things, they launched a HIE-enabled ED data registry, along with a direct-to-consumer patient engagement campaign. These efforts were done in partnership with the Louisiana Health Care Quality Forum, which developed statewide marketing plans for the effort (See John’s interview with the Louisiana Health Care Quality Forum for more details).

They must have created some snazzy marketing copy. As Healthcare IT News noted, between August 2015 and May 2016, patient portal use shot up 31%, consumer EHR awareness rose 23% and opt-in to the state’s HIE grew by 3%, Quality Forum marketer Jamie Martin told HIN.

Not only that, the number of patients asking for access to or copies of electronic health data increased by 12%, and the number of patients with current copies of their health information grew by 9%, Martin said.

This is great news for those who want to see patients buy in to the digital health paradigm. Though it’s hard to tell whether the state will be able to maintain the benefits it gained in its initial effort, it clearly succeeded in getting a substantial number of patients to rethink how they manage their care.

But (and I’m sorry to be a bit of a Debbie Downer), I was a bit disappointed when I saw none of the gains cited related to changing health behaviors, such as, say, an increase in diabetics getting retinal exams.

I know that I should probably be focused on the project’s commendable successes, and believe it or not, I do find them to be exciting. I’m just not sure that these kinds of metrics can be used as proxies for health improvement measures, and let’s face it, that’s what we need, right?

Modern Day Healthcare Tools and Solutions Can Enhance Your Brand Integrity and Patient Experience

Posted on August 11, 2016 I Written By

The following is a guest blog post by Chelsea Kimbrough, a copywriter for Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Chelsea Kimbrough
Digitally speaking, the healthcare market is more crowded than ever – and finding the perfect provider, practice, or physician online can quickly become an arduous task for even the most tech-savvy patient. But healthcare organizations that dedicate the time, effort, and resources to create a unique digital presence, enhance their search engine optimization (SEO), and reinforce their brand integrity can cut through oversaturated search results to acquire and retain more patients.

In today’s consumer-driven world, shopping for the ideal healthcare organization is quickly becoming the norm. More and more frequently, patients are turning toward the internet during their hunt. In fact, 50 percent of millennials and Gen-Xers used online reviews while last shopping for a healthcare provider. And with 85 percent of adults using the internet and 67 percent using smartphones, accessing this sort of information is easier than ever before.

This ease of access has led patients to adopt more consumer-like behaviors and expectations, such as valuing quality and convenience. Healthcare organizations that proactively ensure their brand image, digital presence, and patient experience cater to these new expectations could be best positioned to thrive. By providing convenient, patient-centric healthcare tools and services, organizations can help facilitate this effort throughout every step of the patient journey.

One such tool is real-time, online appointment self-scheduling, which 77 percent of patients think is important. In addition to adding a degree of convenience for digitally-inclined patients, online self-scheduling tools can support your healthcare organizations’ key initiatives – including driving new, commercially insured patient growth. By using an intuitive way to quickly schedule an appointment, potential patients’ shopping process can be halted in its tracks, ensuring more patients choose your organization over a competitor’s. And with the right tool, your search rankings and discoverability, or SEO, could be significantly enhanced.

Reaching patients where they are most likely to be reached is another way to improve your brand experience. Like consumers, patients are often connected to their phones – so much so that text messages have a 98 percent open rate. Organizations that leverage automated text, email, and voice reminders can successfully communicate important messages, boost patients’ overall satisfaction and health, and improve appointment and follow-up adherence – ultimately setting themselves apart from competitors.

Other digital tools, technologies, and communication strategies can help fortify your brand’s digital standing and patients’ satisfaction, including social media outreach, useful email campaigns, and more. Whatever method – or methods – best serve your organization, it’s important they help improve your SEO, enhance patients’ overall accessibility and experience, and support your brand values and initiatives.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

E-Patient Update: Is It Appropriate to Trash “Dr. Google”?

Posted on August 1, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Apparently, a lot of professionals have gotten a bit defensive about working with Google-using customers. In fact, when I searched Google recently for the phrase “Don’t confuse your Google search with my” it returned results that finished the phrase with “law degree,” “veterinary degree,” “nursing degree” and even “library degree.” And as you might guess, it also included “medical degree” among its list of professions with a Google grudge.

I first ran across this anti-Dr.-Google sentiment about a year ago, when a physician posted a picture of a coffee mug bearing this slogan on LinkedIn. He defended having the mug on his desk as a joke. But honestly, doc, I don’t think it’s funny. Let me explain.

First, I want to concede a couple of points. Yes, humor means different things to different people, and a joke doesn’t necessarily define a doctor’s character. And to be as fair as possible, I’m sure there are patients who use Web-based materials as an excuse to second-guess medical judgment in ways which are counterproductive and even inappropriate. Knowledge is a good thing, but not everyone has good knowledge filters in place.

That being said, I have, hmmm, perhaps a few questions for clinicians who are amused by this “joke,” including:

  • Wouldn’t people’s health improve if they considered themselves responsible for learning as much as possible about health trends, wellness and/or any conditions they might have?
  • Don’t we want patients to be as engaged as possible when they are talking with their doctors (as well as other clinicians)? And doesn’t that mean being informed about key issues?
  • Does this slogan suggest that patients shouldn’t challenge physicians to explain discrepancies between what they read and what they’re being told?
  • Does this attitude bleed over to a dislike of all consumer-generated health data, even if it’s being generated by an FDA-approved device? If so, have you got a nuanced understanding of these technologies and a well-informed opinion on their merits?

Please understand, I am in no way anti-doctor. The truth is, I trust, admire and rely upon the clinicians who keep my chronic illnesses at bay. I have a sense of the pressures they confront, and have immense respect for their dedication and empathy.

That being said, I need clinicians to collaborate with me and help me learn what I need to know, not discourage and mock my efforts. And I need them to be open to the benefits of new technologies – be they the web-based medical content that didn’t exist when you were in med school, remote monitoring, wearables, sensor-laden t-shirts, mobile apps, artificial intelligence or flying cars.

So, I hope you understand now why I’m offended by that coffee mug. If a doctor dislikes something so elementary as a desire to learn, I doubt we’ll get along.

E-Patient Update:  When EMRs Didn’t Matter, But Should Have

Posted on July 27, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The other day I went to an urgent care clinic, suffering from a problem which needed attention promptly. This clinic is part of the local integrated health system’s network, where I’ve been seen for nearly 20 years. This system uses Epic everywhere in its network to coordinate care.

I admittedly arrived rather late and close to when the clinic was going to close. But I truly didn’t want to make a wasteful visit to the ED, so I pressed on and presented myself to the receptionist. And sadly, that’s where things got a bit hairy.

The receptionist said: “We’ve already got five patients to see so we can’t see anyone else.” Uncomfortable as I was, I fought back with what seemed like logic to me: “I need help and a hospital would be a waste. Could someone please check my medical records? The doctors will understand what I need and why it’s urgent.”

The receptionist got the nurse, who said “I’m sorry, but we aren’t seeing any more patients today.” I asked, “But what about the acuity of a given case, such as mine for example? Can’t you prioritize me? It’s all in my medical records and I know you’re online with Epic!”  She shook her head at me and walked away.

I sat in reception for a while, too irritated to walk out and too uncomfortable to let go of the issue. Man, it was no fun, and I called those folks some not-nice things in my mind – but more than anything else, wondered why they wouldn’t look at data on a well-documented patient like me for even a moment.

About 20 minutes before the place officially closed for the night, a nurse practitioner I know (let’s call him Ed) walked out into the waiting room and asked me what I needed. I explained in just a few words what I was after. Ed, who had reviewed my record, knew what I needed, knew why it was important and made it happen within five minutes. Officially, he wasn’t supposed to do that, but he felt comfortable helping because he was well-informed.

Truthfully, I realize this story is relatively trivial, but as I see it, it brings an important issue to the fore. And the issue is that even when seeing chronically-ill patients such as myself, whose comings and goings are well documented, providers can’t or won’t do much to exploit that data.

You hear a lot of talk about big data and analytics, and how they’ll change healthcare or even the world as we know it. But what about finding ways to better use “small data” produced by a single patient? It seems to me that clinicians don’t have the right tools to take advantage of a single patient’s history, or find it too difficult to do so. Either way, though, something must be done.

I know from personal experience that if clinicians don’t know my history, they can’t treat me efficiently and may drive up costs by letting me get sicker. And we need more Eds out there making the save. So let’s make the chart do a better job of mining patient’s data. Otherwise, having an EMR hardly matters.