For some of us, it will be hard not to take an increasingly vested interest in how our healthcare is administered considering the rapid changes sprung from the launch of The Health Information Technology for Economic and Clinical Health Act (HITECH) and subsequent meaningful use requirements. To tell you the truth, it’s about time that we started to get our hands on the healthcare data behemoth and put the information to good use to improve the quality of our lives and the lives of others. We can count ourselves lucky enough to live in an era where the healthcare industry is taking meticulous steps towards comprehensive and efficient electronic medical record systems to help create efficiencies and improve caregiver decisions and patient outcomes. Exciting times indeed.
What often isn’t discussed as a result of healthcare’s shift to electronic medical records and the subsequent availability of data once privy to selected eyes is, are we as patients ready for this change? What exactly will we do with all of the health data soon to be laid at our feet for review and analysis? After all, one of the benefits touted by the industry of greater patient accessibility to healthcare records is a rise in quality of care. In fact, according to an article from the Department of Health and Human Services, “we can use the health information ourselves to better communicate with providers and peers, better understand our health and treatment options, and make sure health information about us is as accurate and complete as possible.” Theoretically, improved communication and greater healthcare data accessibility will help to prevent potential medical errors which save lives and help to control the upward spiraling costs to deliver quality care.
Last year, survey results were released by the U.S. National Center for Health Statistics indicating that most people who use the Internet for health information are non-Hispanic whites with a job, higher education and incomes. Largely attributed to easier access to the resources needed to research health related questions, logically we can assume that as healthcare moves to greater data accessibility, those of us who are lucky enough to have access to information could be the ones who benefit the most. However, lower income individuals, the demographic that arguably stands to gain the most from improved accessibility to health records and statistically shown to be the least likely to actually access these records, may have difficulty interpreting data once they are able to somehow retrieve it.
As the healthcare industry opens the floodgates to healthcare data accessibility, what steps are they taking to build tools that help increase record availability and educate patients on how to interpret and use the data they are provided? Clearly, patients play a vital role in the ultimate success of the industry shift to electronic medical records and meaningful use since understanding the history of disparate care is key for providers to piece together the complete patient treatment picture. With patients more willing to share their own healthcare information for the greater good of the whole, tools and resources on how to effectively manage and interpret this data need to be more highly advertised.
One tool developed for quick and easy access to healthcare records is Blue Button, a patient healthcare medical record data portal originally designed for Veterans Administration (VA) patients, now being adopted by private sector healthcare providers like Aetna and Kaiser Permanente. I wondered how easy it would be for me to pull up my own medical record and interpret the data so I went over to Kaiser’s patient portal to see what resources were available. Access to my medical record was pretty easy, I just filled out a form, provided my health/medical record number and was instantly granted access to my electronic medical record (I was a bit alarmed that there wasn’t a more secure identification measure in place to ensure it was actually me asking for the information, but that’s material for another blog post).
The problem for me wasn’t accessibility per se, but interpretation of the information provided. Even though Kaiser had a handy “Health Encyclopedia” available for me to look up each of the tests, how do I interpret the purpose of each lab test performed on me during a visit a couple of years ago in the context of my overall health? Is it important? Was each of the lab tests required? I had a difficult time making sense of the information and what it meant. I wondered how someone else would fare without access to the same data and less education on what resources are available to interpret the information.
I asked Heath Bell, CIO & VP of Revenue Cycle for KishHealth System and recent co-author of the iHealthBeat article, “Portals Hold Promise for Patient Engagement but Challenges Remain” this question:
With the push to digitize medical records and provide patients access to their data, is the healthcare industry doing an adequate job of helping patients to interpret that data for the benefit of their care and the care of others in the aggregate and is healthcare taking the necessary steps to provide accessibility to these records for those who may lack the tools or resources to see them?
Heath responded, “With the push to digitized records and patient accessibility to their records I do not believe that hospitals and health systems have been as successful in providing this access as they will in the future. Many organizations have either begun implementing or searching for tools to implement with regard to patient engagement in their care. For instance, many organizations have implemented a patient portal supplied by their core vendor that allows patients to have some form of access to their records online. However, the intent of population management and improving the healthcare of the community at large will not be accomplished through these viewing tools offering simple results. The level of patient engagement has to accelerate to include not just care provided within the healthcare facilities, but to understand the lifestyle choices the patients are making. Can we gather information from the daily routine of a diabetic patient and include that information along with the results from the test provided at the healthcare facilities to encourage changes in behavior that would improve health? I believe that the integration of these data points are critical to the success of the new healthcare delivery models.
The challenge to this idea is going to hard. First, most of the portal based systems have focused on the transactional items of supplying result data to the patients. Some have evolved to include scheduling and registration components, but not much more. Second, is the challenge of engagement. How does the industry convince the patient to engage in the discussions of populations health when the patient is not sick? Our society today seeks medical treatment reactively and not proactively and changing this cultural mindset could be challenging. Another concern is access to the records. Many citizens are not comfortable using internet or portal technologies. Some areas do not have reliable access to high speed internet or cellular services required to utilize smart phones.
To overcome some of these challenges I believe that healthcare systems must be innovative in their approach to care. There are many opportunities besides just providing the diagnostic test, emergency service or inpatient care to the patients. We must create avenues to promote the healthy lifestyle in an effort to improve the health of the American population.”
What do you feel are some proactive steps the healthcare industry taking to help engage and educate patients on how to interpret healthcare data and what infrastructure is being put in place to help those without access to computers gain entry to their electronic records? With patients playing a key role in the ultimate success of the push towards an electronic medical record delivery model, the race to education and accessibility seems to be off to a slow start.
John Trader is a public relations and marketing manager with M2SYS Technology.