Giving Patients What They Really Want from HealthIT

It's common knowledge that the more engaged a patient is with his physician and medical practice, the more compliant he will be with treatment plans and advice. It's also clear through various studies that a more engaged patient reduces healthcare costs, from savings in readmission costs to more informed patients choosing less expensive options for care.

But in an increasingly digital age, the divide between patients and their own personal health data, which helps to enhance connections with physicians, is still very wide.

Armed with smartphones, apps, and instant access to the Internet, patients want to take advantage of the health IT offered by their medical practice to access their own health records and are open to a more active role in their own health management, according to Jan Oldenburg, a senior manager in Ernst & Young's Advisory Health Care Practice.

"[Patients] have access to information they've never had access to before," Oldenburg said at her presentation at this year's Healthcare Information Management and Systems Society (HIMSS) Annual Conference in Chicago. "It's the democratization of information. They may have more information on a disease or condition than the doctor has."

But it is the disconnect between patient technology and healthcare offerings that prevents better patient engagement.

Oldenburg noted that companies like Samsung and Apple have an increasing presence in the healthcare marketplace. She mentioned a Google pilot where if a person is searching for knee pain, for example, an avatar pops up and asks the user if he would like to connect via telehealth to a physician to discuss the condition further.

"That's exactly the kinds of services [patients are looking for]: more convenient, more digital … we are starting to permeate people's expectations of what they want out of healthcare," she said.

What patients want

Oldenburg and her colleagues on the HIMSS Connected Patient Committee created a survey of healthcare consumers asking about their roles as patients and consumers to improve personal health engagement.

Early statistics from the survey indicate that on a scale of one to five (with five being extremely interested, one not interested at all) consumers were very interested in the following online administrative capabilities from practices; scoring each between a four and a five:

• Ability to make, cancel, and view an appointment;

• Ability to refill prescriptions;

• Ability to complete a pre-visit form; and

• Ability to research health issues.

Furthermore, 84 percent of respondents said if they could reinvent the healthcare system to be more consumer friendly, they would like "all my clinical data [to] be in one place." Seventy-five percent said the biggest piece of digital support they would like is the ability to easily see all their data in one place.

"Nobody is doing a good job of getting consumers their records," said Oldenburg. "If [a vendor] can figure that out, they'll be the walk-away leader in the market … [Seeing data in one place] seems like it should be simple, but it is not."

She encouraged medical practices to evaluate their digital tools, especially to "think beyond basic meaningful use" requirements and revamp work flow and incentives to support digital tools, and have staff and physicians encourage their use. Oldenburg also stressed integrating patients and caregivers into the process through a patient advisory panel, or simply just listening to what it is they want from digital interaction.

"They are your consumers," she said. "You want to please them."

Moving past meaningful use

Oldenburg mentioned the recent proposed rule by CMS to adjust the requirement in the Stage 2 rules from a 5 percent threshold of patients downloading, viewing, and transmitting their electronic health data to just one patient. The same threshold for patients e-mailing or securely messaging their doctors also dropped from 5 percent to a single patient.

While noting the hardship physicians nationwide were describing to reach the 5 percent mark, Oldenburg said that while the proposed one patient threshold proves practices "have the capacity" to share health data electronically, more should be done.

"One patient is not enough," she said. "[One patient] does not make it an organizational priority … and say that you've embraced this and made a culture change."

On the topic of physicians being currently penalized for not meeting the 5 percent mark, Oldenburg said, "I understand the argument [of a hardship], but I think it is a misnomer to think physicians have no control over patients asking for access."

She pointed to current activities by physicians such as telling patients what prescriptions to take and how often, then reporting that back to the practice, or encouraging online access to labs as just two examples of physicians being proactive with patient engagement.

"Those actions are having a direct impact on the number [of patients] taking action in their health," she said. "We need to say we do have control … and there are things we can do to affect the patient population."