Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Can Patients Be Trusted?

Written by:

“Pay no attention to that man behind the curtain!”  This was how Dr. CT Lin, CMIO at University of Colorado Hospital & Health Sciences Center, opened his talk at the Healthcare Forum.  Dr. Lin’s premise was that we have kept healthcare information hidden from patients for far too long.  Giving patients access to their medical record does not create confusion and extra work for providers, but instead there is strong evidence in Dr. Lin’s research that patients are highly engaged and satisfied with access to their record and it does not create added burden on providers.

While the mystique of the all knowing, all powerful doctor is a strong one, healthcare is changing.  We’re quickly moving from the all knowing, no mistake doctors, to a more realistic paternal collaboration between doctors and patients.  No doubt this change is a hard shift in medical culture.  Take a simple look at the 5th century BC Hippocratic Oath [emphasis added]:

“I will impart a knowledge of this art…to pupils who have signed the covenant, and have taken an oath according to the medical law, but no one else.”

In the 70’s we started to see the very first shift away from closed records and medical knowledge when patients were allowed to access their paper records.  In the 80’s and 90’s we started to see the first patient portals.

Dr. Lin described the old healthcare mentality as follows:

  • Knowledge is power.  Respect my studies.
  • I am too important for clerical tasks.
  • Patients do best when they do what I say.
  • There is nothing wrong with the way I work.

Then, he suggested where we are headed in healthcare:

  • Collaboration is powerful.
  • Communication improves safety.
  • Connection fosters participation.
  • Change requires a burning platform.

This shift requires us to move from a physician centered healthcare system to a patient centered healthcare system.  Is it any wonder why physicians feel threatened?  However, Dr. Lin has studied how this shift impacts both doctors and patients and the results are profound.

Dr. Lin discussed these results during his presentation at the Healthcare Forum (embedded below):

His presentation focused on studies he conducted on: online messaging, online release of test results, and online release of doctor notes.  In each case, Dr. Lin presents the fears many doctors have of connecting with patients in this manner and also the many doctors who see potential benefits of pulling back the curtain.  Some of those fears include: “This is a crazy idea; the phone will ring off the hook” and “Patients will be more anxious.”  One doctor only agreed to participate in his study because he thought that Dr. Lin was doing a “rigorous study” and he was certain that the study would validate his fears.

The results from his research consistently showed that the “floodgates” of patient requests didn’t open and where studied there was a dramatic improvement in patient satisfaction.   The irony of people’s reaction to the study was that it varied based on the clinic’s perspective.  For example, a busy clinic that has more patients than it can handle was happy to reduce the number of patient calls while a slower clinic was not happy with that result.  An even more surprising result was doctors who found they were better doctors after the change.

Plus, there were plenty of anecdotal examples of patient benefit that were not captured in the qualitative portion of the study.  For example, one patient who had been given access to their physician’s notes reported this experience: “I lost my luggage while traveling.  I went to a local doc and said: ‘If you have Internet Explorer, I can show you my chart.  Could I have a few days of my meds?”  Access to the physician notes changed the entire experience.

Dr. Lin’s research has also been confirmed by a 250 doctor initiative called OpenNotes which came to similar conclusions.  When you involve the patient, the world does not come to an end.  Patients are happier, more satisfied, more connected, and more empowered.  Dr. Lin concluded, “Patient centered information technology is fast moving, often out of focus, but always exciting.”

The Breakaway Group, A Xerox Company, sponsored this coverage of the Healthcare Forum in order to share the messages from the forum with a wider audience.  You can view all of the Healthcare Forum videos on The Healthcare Forum website.

August 14, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

What Information an HIE Should Pass?

Written by:

I had a post by Dirk Stanley, MD recently pointed out to me where Dirk discusses the challenge of deciding which information an HIE should pass. Dirk is the CMIO at a hospital and also a genuinely nice guy. He frames the answer to the HIE data passing question really well:

And after a rousing discussion, the answer I heard was this :Everyone has a different opinion.

I guess it’s entirely understandable… ICU docs, PCPs, surgeons, specialists, hospitalists, and everyone else has a common goal – making the patient healthier – but they have different training and thus they all have different needs. This is why when I hear docs say “I just need the important information!“, I smile because ultimately, all of the information in a chart is important - It just depends on your context and clinical needs.

So I’m left with the ultimate Informatics challenge - How can we get the right information to the right person in the right place in the right time in the right way? Especially when everyone has a different opinion on what the right information is?

He then offers this zinger which describes the real core of the problem: “Looking at the current buffet table of documentation, it’s no wonder that every doctor has a differrent opinion of what they need. There aren’t really any hard standards for clinical documentation.”

Dirk then goes on to describe his solution to the problem which essentially revolves around the idea of a new type of note that can be transferred. You can read all the details in his post.

Reading through Dirk’s thoughts on the subject I’m reminded of the conversations that surrounded the creation of CCR back in the day. They seem to have taken a very similar approach to what Dirk describes. I wonder what Dirk thinks of the CCR (now basically merged with CCD) standards that are already out there. Do they not cover what he has in mind? Are their gaps in the CCD standard that don’t cover his “new note?” Could we just improve the CCD standard to cover those gaps? I’ll ping Dirk and hopefully he’ll join the conversation.

The real challenge when looking at what data should an HIE pass is that computers aren’t very good at understanding context. I’d be interested to hear people’s thoughts about this and how we’ll solve this problem going forward. My gut feeling is that we need to start with something that will solve a lot of problems for a lot of people. We don’t need something that will solve all things for everyone from day one. We can incrementally improve the exchange of data as we go forward.

March 23, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Health Tech Next Generation Conference – See You in San Francisco

Written by:

I haven’t been to a healthcare IT conference in a little while. Mostly, because I hadn’t seen one that I really wanted to attend. So, I’m excited that August 12th I’m going to the Health Tech: Next Generation Conference in San Franscisco, CA.

I’m actually going to be there the whole weekend since there’s a WordPress conference happening that weekend as well. Plus, there are a number of people I’m planning to meet with while I’m there. If you’re in San Francisco that weekend, let me know so we can get together. I always love meeting readers of this site.

I’m really excited for this healthcare IT conference. They have the amazing Guy Kawasaki as one of the keynote speakers. He’s a dynamic person and I can’t wait to see him speak in person for the first time. Plus, I’m sure he’ll offer an interesting “outsiders” perspective on healthcare IT. I believe every attendee gets a free copy of his book “Enchantment: The Art of Changing Hearts, Minds, and Actions.”

I’m going to be moderating a panel about EMR 101. Most long time readers of this site won’t likely want to attend. Although, hopefully it will be a great session for those doctors who are diving into the EMR and EHR world. So, if you’re a doctor near San Francisco, come and learn. Nice thing is that it’s only a one day event so it’s not a huge ordeal. Plus, there are some other really smart people that will be at the event as well.

Here’s the full description of the Health Tech healthcare IT conference from their press release:

HealthTech:NextGeneration will host it’s first upcoming Conference & Exposition at the Hilton San Francisco Airport Bayfront Hotel, Burlingame, CA on August 12th 2011. This one day comprehensive event will assimilate leaders & professionals in Healthcare & Information Technology under one roof. It will showcase up-and-coming strategies and technologies to tackle today’s healthcare delivery obstacles, shaping and advancing the healthcare industry forward into tomorrow’s paradigm of patient controlled environments.

HealthTech:NextGeneration will feature expert speakers from both the Healthcare and IT industries, including renowned author Guy Kawasaki & Dr. Mattison who is CMIO at Kaiser Permanente. The track sessions will address crucial topics such as Data Privacy and Security, Meaningful Use of Electronic Health Records, Role of Social Media, Cloud Computing In Healthcare, Health Information Exchange, Funding Opportunities for Healthcare Businesses and Global Healthcare Systems. The conference is designed for Healthcare & IT Executives, Consultants, Entrepreneurs and Professionals. Attendees will also include Policy Makers, Vendors, Insurers, Medical Administrators, Directors, Managers and VCs.

I hope to see a number of my readers at the event. If you can’t make it to the event, but are in San Francisco, definitely drop me a line and I’d love to meet up with others as much as possible. If enough are interested we could do a dinner event or something one of the nights I’m there.

July 30, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.