Under the new patient-centered medical home paradigm we, obviously, want to put the patient back at the center of the healthcare experience. New tools and techniques incorporated into an electronic health record (EHR) can build a system that helps patients achieve optimal care under a variety of different circumstances.
My dream is to create an EHR that works with our patients and our providers, to more effortlessly and effectively allow them to improve their health.
Right now, as many of us using these EHRs will affirm, there’s a lot of clicking for not a lot of benefit. Working with them clearly creates an (overwhelmingly) detailed and full recording of some semblance of what went on at the office visit, but it is probably not really providing the added value that we need it to.
We want the EHR to become a living, breathing, active partner in the healthcare process. Wouldn’t it be nice if the healthcare record recognized that something was overdue and alerted patients and us through the patient portal, rather than waiting for all of us to get around to recognizing it?
The system could be trained to realize the patient had not come in for refills, or has not come in for a visit in over a year, or needed reminding about previously ordered testing, consultations, healthcare maintenance items, or taking medications.
Many new systems are being created that collect data from our patients, send reminders to their phones or to their emails, that track their calories consumed, or how much sleep they got.
Many more alerts can be created to remind patients to take medicines, or that they’re overdue for some home monitoring such as blood pressure or checking fingerstick glucose readings.
I’m not saying that we need to create a more authoritarian or paternalistic system, but one in which we can engage our patients and get them to team up with us, to help figure out how to get them through all of these things using the EHR to their benefit.
Harassment is not what this is about, badgering patients is not what this is about, making them feel guilty is not what this is about. We hope that this creates an environment where patients feel more engaged, once again at the center of their care, so that they feel more in charge and empowered by the healthcare process.
Right now, through our patient portal, I can send the patient a widget, which allows them to enter their blood pressure from a home unit, and send me their values, to help track at home how their blood pressure is doing on a medicine or on a nonpharmacological intervention. I can also send them one that allows them to enter their weight, or their blood glucose readings, along with several other home monitoring modalities.
These types of interventions return the patient to the center of the care, putting them in control, and helping me get more information to help bring them through to the other side.
This sort of thing speaks to the core of the patient-centered medical home. Their care continues beyond the office visit, and the patient begins to feel that their healthcare system, their health itself, is continuing well past the confines of the office visit.
Every time they take their blood pressure, every time they record their exercise, every time they get encouraged to come back in for a follow-up appointment, they’re more engaged in this process of bringing them to a better health state.
We as practitioners cannot allow this to come about simply as a result of bureaucratic pressures from the forces that are creating “meaningful use”; it is much better if this comes about as a result of an organic process whereby we as practitioners, along with our patients, figure out new patient-centered ways for technology to help them reach their health goals. Source
