ONC goes Hollywood to showcase health IT

December 07, 2011 | Mary Mosquera, Contributing Editor

WASHINGTON – The Office of the National Coordinator for Health IT is going Hollywood, or at least contracting a California production company, to create a video to explain to the public the value of health IT and how individuals can engage with their providers.

The video is an example of ONC’s expanded efforts to get consumers more involved in their health and healthcare and encourage them to raise the importance of electronic health records with their providers, according to an ONC official.

ONC’s strategy includes supporting a change in how consumers view themselves as receivers of healthcare, to feel empowered to request access to their information, take action with their data and work as part of a team with their providers, said Lygeia Ricciardi, senior adviser for consumer e-health at ONC.

“A lot of what we’re trying to do in shifting attitudes is to make things personal, not just sharing the facts but telling stories, putting the ‘I in health IT’,” she said Dec. 5 at the ONC Town Hall Meeting on Consumer Engagement at the 2011 mHealth Summit.

ONC’s website has tools and materials available for download that can assist consumers in managing their health in their daily life.

Among its strategies, ONC has brought together 250 healthcare, technology, consumer and other organizations so far to commit to educate and inspire individuals about why they should request their health information, she said. The participating organizations that also hold health data, such as health IT and exchange vendors, have pledged to make access easy for consumers, such as through Blue Button and the Direct Project.

Blue Button, initially available just for veterans and Medicare beneficiaries, is a feature in electronic patient portals that lets individuals download their health information in simple ASCII format into a personal health record or other electronic media. Direct is secure email for point-to-point health information exchange.
Many consumers do not understand the importance of having access to their data or what they could do with it. Ricciardi said that ONC would develop messages to build awareness, such as through pictures or animation.

Some messages may be action oriented, such as “You should choose a provider who uses health IT. Why? It’s convenient for you, and you’ll get better quality, safer care.” Or, “Go get a copy of your health information. Why? So you can try to understand it and check to make sure no information is missing or wrong,” she said.

The animated video that ONC has contracted for will have Spanish and English versions and last three to five minutes. Shorter versions will be targeted for YouTube and other channels, according to Ricciardi.

ONC also will tap an industry partner to run crowd-sourced video contests throughout 2012 to highlight personal experiences using health IT and mobile applications to manage their diabetes and other chronic conditions.

Mary Mosquera

Senior Editor for Government Health IT

Follow Mary on Twitter @GovHITreporter

Reader Comments (5)Login to Post a Comment

pjoseph says: Connection to patients

December 09, 2011 | 12:16PM GMT

Two respected physicians in previous comments push back on ONC's attempt to bring the healthcare consumer into the EMR discussion. Perhaps the Hollywood reference gets in the way.

But I think the intention of the ONC's effort is to educate patients on the benefits of electronic records. This is terrific and overdue.

As a healthcare consumer, I want to know how healthcare reform efforts, until now focused on bureaucracies and healthcare providers, will affect me in the future. One specific: I long to see a graph that shows me how my cholesterol has changed over the past 5 years. Can't do that without electronic records.

I compare the need for electronic records for my healthcare to electronic records for other important issues in my life and invite providers to consider:

-- Would I (or any physician for that matter) entrust my 401K or investment portfolio to an organization that didn’t have electronic records? Why would I entrust my health to one?

-- I would think twice about banking with an organization that didn’t allow me to view my latest transactions online. Why would I be willing to forgo that capability for my health?

-- My VISA account notifies me if something isn’t quite right with a transaction. Shouldn’t my healthcare providers have that ability?

Healthcare reform is about better patient outcomes ultimately. ONC's attempt to bring the patient into the process should be applauded.

Duncan says: ONC's goal should be applauded, not their methods

December 19, 2011 | 1:35AM GMT

ONC's goal should be applauded, not the methods with which they are attempting to achieve that goal.
As noted in my comment, our local health system has effectively used an EMR for over 10 years. We have involved our patients in their care through our EMR's patient portal for about 7 years and we currently are further developing the portal and making an effort to promote its use by more of our patients. We believe like you that the EMR and patient involvement is important and will improve patient care.
Most of my comments have revolved around the methods with which the ONC is going about their implementation of what they consider meaningful use of the EMR. I am concerned that their overzealous push to get all providers in the country to use an EMR is going to be counterproductive due to their short time line and unreasonable demands for data entry by the provider.
You are right that "healthcare reform efforts, until now focused on bureaucracies and healthcare providers." The problem is that it has "focused on", but has not INVOLVED healthcare providers in the private sector to the extent it should in the design of the Meaningful Use agenda.
Healthcare providers should be encouraged to seek an EMR with a patient portal, learn to use it and once they have learned it and developed appropriate workflows, they should encourage their patients to use it. To pressure the doctors to rush to do this with threats of financial penalties and crafting public sentiment with Hollywood theatrics which will put pressure on the doctor, is not good methodology.
Your investment portfolio, bank account, and VISA account are all about crunching numbers. The world of patient care is much more than crunching numbers and much more complicated to computerize. It can't be computerized to the extent that financial businesses can because it involves human emotion, human physiology, and the art of medicine which cannot be reduced to computer algorithms. Converting financial information regarding portfolios, bank and credit card accounts to digital spreadsheets and other digital formats works beautifully. Bringing computerization into the arena of patient care is a whole different ball game and has to be handled with care. Comparing these two entities is not a valid analogy.
When a patient chooses me to be their orthopedist I feel a heavy sense of obligation and responsibility to help relieve their ailment which is affecting their life. They have entrusted their care to me and I want to help them the best way I know how. I don’t want the government, bureaucrats, and computer software programmers dictating to me how I am allowed to provide that care. As David Hagar MD said in one of his comments in this newsletter, “How the medical profession chooses how to do this [provide patient care] is not up to the technical IT profession ... or the politicians and bureaucrats, who know even less about the real implementation of IT in the clinical world.”
I am not saying that usage of the EMR and preserving the art of medicine in patient care are mutually exclusive. The EMR is a good tool but that is all it is – a tool. It does not focus on the art and the human side of medicine. I have faith that the current and future medical students and residents will be learning to mix the two in a suitable fashion. A gradual transition and evolution as these students become the majority of practicing physicians will bring about the necessary computerization of patient care. Currently, however, pushing the EMR down the throats of physicians today in Meaningful Use’s short timeline and with the baggage that comes with Meaningful Use (such as time consuming data entry) is not the right process. The software companies are being held to this timeline as well and as a result the products they are producing are not as refined as they need to be for practical and functional usage by the provider. “Haste makes waste” and a lot of the programs are broken and yet the providers are being forced to buy and use these broken programs. Just like it will for providers, time and evolution will get the EMR software up to speed.

I have been in practice for 34 years. It is discouraging for me to see my colleagues becoming frustrated with the government, insurance agencies, and other outside powers forcing a change in the focus of medicine from the art of medicine to the business of medicine. This started happening around the mid 80’s. We have been progressively forced to become businessmen to survive and keep our practices going. By far the majority of physicians in practice had no business training mixed with medical training. Now, with Meaningful Use, we are being forced to computerize the practice of medicine and divert our attention to being data entry people. That is layering on yet another source of frustration.
The underlying theme of the frustration I see in the feedback I get as a EMR physician facilitator for the physicians in our 110 physician private multispecialty group, is a cry for (as jconcannon put in one of his replies in this newsletter) “respect for our role as physicians to protect the human side of the doctor-patient relationship."
Our medical records used to be a narrative of the office visit with our patient. That documentation can’t, and shouldn’t be, reduced to macros, templates, computer clicks, drop down menus and fill in the blanks that don’t accurately reflect the human side of the patient encounter. To quote jconcannon again, “Narratives show that we actually listened to a patient, or at least, know the patient well enough to have been caring and empathetic during the encounter. “ “Boiling down the practice of medicine to checklists to capture 'meaningful use’ is a very disturbing concept that removes any sense of the ‘art’ inherent in medicine.” “Unfortunately, such narratives seem to be of little importance to the bureaucratic bean-counters that drive EHR down our throats, partly because the almighty ‘meaningful use’ criteria are not met while practicing the artful side of medicine.” Protecting the human side of patient care and the art of medicine which can be lost in the cyber world “is the right thing to do if we’re to be the professionals we claim to be, and not robotic Cyborgs; for the practice of medicine is an encounter with a human being—not a data set.” In my reply to the same article jconcannon was referring to I stated, “Now that the ‘bureaucratic bean-counters’ and the data crunchers have gotten on the meaningful use cyber wagon and are flooding the Quality Measures Workgroup with their suggestions, the demands for data entry are potentially going to smother out any perception by many doctors that the EMR might be a useful tool for patient care. Telling doctors they have to use an EMR and simultaneously making demands for entry of data that they don’t feel is pertinent to the care of their patients is a very poorly thought out approach.”
Doug Duncan MD

darrelldk says: Account numbers can be changed. Social Security numbers can't

December 09, 2011 | 3:08PM GMT

“Would I (or any physician for that matter) entrust my 401K or investment portfolio to an organization that didn’t have electronic records? Why would I entrust my health to one?” – pjoseph

According to the Ponemon Institute’s 2011 Benchmark Study on Patient Privacy and Data Security which I mentioned earlier, breaches of patients’ Protected Health Information (PHI) from health organizations you prefer increased 10% to an estimated $6.5 billion a year. Do you think that makes your healthcare more expensive or less expensive?

What’s more, almost 30% of the providers reported that one consequence of data breaches was medical identity theft. When one’s medical identity is stolen, allergies and other important health facts can be imperceptively changed to suit the thief’s customer. Such a life-threatening danger simply cannot happen with paper dental records, and my patients like it that way.

Physicians have no choice. They lost control of medical care to Gingrich’s stakeholders, and must adopt EHRs to stay in business. On the other hand, because the business of dentistry is much simpler, dentists are far less susceptible to tyranny than physicians.

D. Kellus Pruitt DDS

Dr Duncan says: Hollywood? Are you serious?

December 08, 2011 | 12:39AM GMT

This sounds like a campaign by the ONC to force providers (by public brainwashing and public pressure)to give in to the ONC’s plan whether the providers on the front lines of providing daily healthcare think it is good for the patient or not. So the ONC is saying let’s take the providers out of the decision tree (unless I missed something in the 6th paragraph.)
Since the ONC’s mission is to achieve “Meaningful Use” by all providers, I am assuming that the statement “You should choose a provider who uses health IT. Why? It’s convenient for you, and you’ll get better quality, safer care” means the patient should choose a “Meaningful Use” doctor. However, a specialist can use an EMR to improve patient care very effectively without fulfilling all of the “Meaningful Use” criteria that applies mainly to comprehensive care by a PCP.
To be considered an effective user of an EMR should it really be required that a surgeon repeat the smoking counseling that has already been done by the PCP or to maintain the PCP’s or endocrinologist’s or cardiologist’s medication list that has no meds prescribed by the surgeon? Are surgeons really qualified to do the latter? This example is just a tiny portion of the problems the “Meaningful Use” agenda has created by trying to pour PCP’s and specialists into the same mould and impose on specialists the criteria that applies to a PCP’s practice. You are shooting yourselves in the foot to push the same criteria onto specialists. They will reject the EMR because of these unreasonable demands. Make the criteria reasonable for the specialists and they will adopt the EMR because they recognize its real value. Allow the specialists to become “Meaningful Use” doctors by means of criteria that are appropriate for them.
So to push its agenda, the ONC has to resort to theatrical measures? Is there something wrong with reality? Theatrics is what lawyers in the courtroom use to sway opinion to their side of the issue that they have been hired to present regardless of whether it stands to reason or results in true justice. Theatrics is what politicians use to push the agenda that has been bought by their political campaign contributors. We know how broken the judicial and legislative systems are. Go ahead ONC, go to Hollywood to push your agenda so our country’s health system will be as broken as our political system.
Don’t get me wrong, I think the EMR is an extremely valuable tool. That is why I developed one for my personal use in 1984 with a database. That is why I was instrumental in getting our 70 physician (now 110) specialty clinic to go electronic and get rid of paper in 2001. We were doing it for the right reasons then. It worked. It improved the efficiency with which we provided care for our patients and the improvement in patient care that resulted is indisputable. There is no question that we could improve our usage of the EMR. However, since the demands of “Meaningful Use” on our specialists came along there is so much frustration that it is difficult to implement further improvements. The demands have replaced efficiencies with inefficiencies. Instead of a self motivated effort to further develop the EMR for the right reasons, we are forced to develop it to meet criteria developed without proper input from all types of providers in order to avoid being punished by the government. The stimulus money does not offset the frustrations of the unreasonable demands and loss of income due to inefficiencies. The ONC’s effort to force “Meaningful Use” on providers by creating public opinion with Hollywood theatrics will be recognized by providers as totally inappropriate.

Doug Duncan MD

darrelldk says: Exaggeration of EHR benefits

December 07, 2011 | 2:39PM GMT

"... you’ll get better quality, safer care." Not so fast, Hollywood.

Whether EHRs improve the quality of care or makes care safer is far from proven for physicians.

This week, the Ponemon Institute said 96% of healthcare organizations had suffered breaches of patients' identities in the last 2 years. That's not safe.

And as far as dental practices are concerned, electronic dental records not only do nothing to improve dental patients' quality of care, but they are far more dangerous for both patients and dentists than paper records and far more expensive, not even counting the cost of HIPAA compliance - which will never be cheaper. Get real, ONC.

D. Kellus Pruitt DDS