One of my readers emailed me about a presentation he was looking at doing about EMR software and consumers. I was really intrigued by the idea of presenting on the benefits of an EMR to the consumer (Translation: Patients). I’d spent quite a bit of time thinking about the benefits of an EMR to doctors, but I hadn’t put as much thought and effort into the benefits of an EMR to patients.
Here’s our initial brainstorm on the benefits of an EMR to patients. Feel free to add to the list in the comments:
-Online Appt Scheduling
-Online Prescription Refills
-Online Patient Information
-Online Forms (possibly pulled in from a PHR)
-e-Visits (this is a controversial one)
-Secure communication with doctor
-Recall/Reminders Electronically
-Patient participation in health record (ie. diet journals)
-Better point of care
-Clinical decision support
-Better access to your health records
-Less errors
-Lower cost
-Better collaboration and communication between primary care and specialty Drs
No doubt some of these benefits should have a ? mark by them. Although, I like the idea of looking at the EMR from the patient perspective. I do after all think that consumers might be the key to “forcing” broad EMR adoption.
Hi – that’s another good topic. Yes, this could be a differentiator when consumers chose their family physician sometime in the near future.
Cheers
Patients choosing one doctor over another because of EMR implementation? I doubt it, unless everything else is equal — which it never is. Consider these variables: reputation, office location and hours, doctor-patient “chemistry”, areas of interest, and many others that would easily trump even a feature-rich patient portal/EMR back-end.
Last time I had to switch primary care physicians, I carefully looked for someone who claimed a special interest in sports medicine and whose office was relatively nearby. I live and breath technology, but even I consider the patient portal thing to be unimportant when compared to the other variables.
Seth,
I can agree that it won’t be the number 1 factor. However, I can see the next generation of patients really wanting the online services. So, it could be a part of the decision that if nothing else breaks the tie between 2 similar physician offices.
I’ll add a few more:
– Customers can win more frivolous lawsuits because their doctor documented the encounter with a point and click interface.
– Patients get to see more error because the complaint-driven template did not allow for proper order entry and documentation, and the EMR introduced preconception bias.
– Patients get to have even less face time with doctors who are struggling with buggy and cluttered software.
– Patients get to spend more time looking at the back of a laptop and seeing the glow of a computer screen reflected on their doctor’s vacant stare.
– The majority of patients, who have neither an interest in or the means to engage in their healthcare through the internet, will get to find themselves even more depersonalized, confused and marginalized by a complex system.
– Hypocondraics will get to further misinterpret and misunderstand their records, and can then e-mail their doctors about why they should be on the latest designer drugs.
– Patients get to pay for the unanticipated costs associated with an EMR.
– Patients get to wait longer for an appointment because their doctor’s efficiency has been cut in half.
– Patients get to benefit from increased miscommunication between their doctor and consultants because they are using EMR consult request forms instead of speaking on the telephone.
I supposed Health IT folks can be forgiven for thinking that most patients can navigate a web browser or care whether their doctor uses a computer, but what most patients want is good doctors who have the time to really listen. So far, IT has laid waste to the doctor-patient relationship, introduced error, increased cost, decreased efficiency, and barged its way in without any real understanding of what it is we do. I agree that EMR can be a differentiator, as I think patients will prefer to see a doctor who looks her patients in the eye, while swiftly jotting a note with a pen.
While all the online stuff is great, I think the most important point for providing care for the patient is the last item: “Better collaboration and communication between primary care and specialty Drs”
As Regional Care Facilities continue to expand their footprint by either opening new offices or incorporating private practices into their group, more patients are being exposed to the value of EMR’s as a way to provide continuity of care. A facility here in Ohio is just one of those places. No matter which office, practioner, specialist, or affiliated hospital you go to, they have a complete, up to date file available to review before providing treatment.
If your primary care physician is not affiliated with one of those larger entities, the chances are that each provider or specialist you see will not have access to this same information.
How many people carry around a copy of their most current medical records? Probably very few. A trip to the emergency room results in a doctor relying on the patient to remember all allergies, previous conditions, etc. How can this method provide for better care than accessing the patient’s complete medical record electronically?
The threat of small practices being driven under does not come from meeting Meaningful Use criteria. It comes from the fact that we live in a world where people have immediate access to just about every piece of information there is…except to our own medical records. These larger entities, to a degree, provide this, at least to the point where patients feel confident that the treatment they recieve will be based on factual information from the records maintained by their multiple physicians, not from the bits and pieces they remember each time they see a different doctor.
I think I have said this before.
Referring to patients as consumers is a problem for me. Patients are beneficiaries … not conventional consumer. Those in the selling EHR business or elsewhere in the health care vendor perifery who think the patient uniformly decides who provides their care are not right.
Unless you are in a PPO … the decision as to who your doctor and hospital is … is more a factor of what your plan or Medicare accepts. That and who you can get in and see.
I don’t discount many advantages of an EHR in improving the convenience for the patient … but qualifying an EHR as …
-eVisits … (implications of telemedicine as an EHR component is a ver 3.0 conversation … not 1.0)
-Secure comms with doctor … how does the doctor know with whom he is communicating … and how does the patient know its the doctor)
-Better point of care (what does that mean?)
-Clinical decision support (very debatable. Only academics and government regulators really think this is true)
-Better access to your health records … (and access to anyone who can break your password code or can crack into the ‘top secret data vault’)
-Less errors. (Debatable… just different errors or errors of MASSIVE proportion)
-Better collaboration between PCP and specialists … (only if they have compatible systems … and there are secure share protocols)
All you IT dudes need to focus on the basic … and get that fielded and running right. Don’t become so smart that you will try and deal with HIPAA issues electronically.
Develop and deploy 1.0 … anything else you say slows down the process.
I think this topic is a very interesting perspective from which to consider EMRs. I did find your initial brainstorm on the benefits very interesting, particularly since most of these benefits do not represent new advances from the technology but are instead basic access and communication issues. While the technology may improve convenience and hopefully reduce paperwork, I still think that the greatest benefit from EMRs for patients is tied in to the benefits that it provides for their doctor to provide them with the best care. Whether a medical practice utilizes EMR or web portals, I believe that ultimately the most important thing for patients will still be excellent medical care and the strength of their doctor-patient relationship.
As an IT Dude and patient I have encountered some problems with the “old school” medical communication network. Just recently, I was referred to three different specialists. I had to fill out a lengthly questionare in the lobby of each Dr Office – all, for the most part, were asking the same questions! Most of my responses were entirely from memory – thankfully, I had a list of my medications and dosages available.
Ideally, from both a patient’s and provider’s perspective – this trivial, but possible life dependent information should have been available from an EMR. In-turn, each specialist could enter their findings into the EMR which would follow the patient to the grave (hopefully not from the present ailment).
Most Physicans use state-of-the-art equipment to help in diagnosing their patient’s problems. Why stop there and relay their findings by Town Cryer?? Don’t be afraid of technology – embrace it!!