Happy New Year to our readers. Both Mark and I are pleased that you take the time to read our blog posts and greatly appreciate your positive comments. We look forward to interacting with you in 2011.
Like many people, I opted to take time off for the holiday season and generally unplugged from all online activities. Just prior to taking time off I published a blog post exploring the concept of the roles that individuals play when using online health applications and resources. This post generated several comments. Unfortunately, since we moderate all comments on this blog, these comments were not reviewed and have not yet been approved for posting. I apologize to those people who took the time to offer their feedback that I did not address these comments in a timely manner.
I have been involved in many conversations and listened to numerous presentations that use the words “consumer” and “patient” interchangeably, often in the same sentence! While I will readily admit that we can get hung up on words at the expense of getting anything done, I think that the inaccuracy in our use of language can actually impede progress. Such is the case, I suggest, with regard to the words “consumer” and “patient”.
While the debate as to whether the individual who is the subject of care is a “patient” or “consumer” may be heated, both sides of the argument seem to be focused on classifying the individual as either a “patient” or a “consumer”. I contend that “patient” and “consumer” refer to roles that we play and that we can shift between these roles depending upon the situation. I define these roles as follows:
- In the consumer role an individual will make choices of about the services that they need, when they need them and from whom they receive them. In this role, the consumer may engage service providers outside the traditional healthcare system such as a consumer health portal or consult with other individuals in on-line communities of interest.
- In the patient role an individual has made choices regarding the healthcare services that they wish to receive and are engaged with one or more healthcare providers for these services. Just as banks and courier companies are using ICT to streamline operations and engage their customers in ways and at times that are most convenient to these customers so too can healthcare providers use ICT to engage their patients.
Numerous surveys and studies confirm that Internet users have a strong interest in searching for information related to health and medicine and interacting with others who suffer from the same disease or condition. Yet, despite this strong interest in using the Internet for health related purposes, many so-called “personal health record” applications have floundered. Examining these successes and failure reveals a pattern of behavior that is best explained by categorizing the role in which the individual operated when using these applications as either “patient” or “consumer”. Applications that are designed for the role in which the individual is operating are more likely to garner an active and engaged audience.
I think it is time to better define what we mean by the words “patient” and “consumer” and to be more careful about how we use these words. The distinction is critically important to understanding how best to use IT to help people manager their health.
The Delaware Medical Society is helping its members use IT to encourage greater patient engagement. According to an article in HealthcareIT News, the Delaware Medical Society is “making web-based tools available to its members to boost doctor-patient communication and is also providing free personal health records to all state residents” through a partnership with RelayHealth.
The Executive Director of the Delaware Medical Society, Mark A. Meister, Sr., notes that the “The primacy of the physician-patient relationship means that physicians are in the best position to have the greatest influence on patient care and the individual choices a patient makes.” Physician endorsement of consumer eHealth applications and automated downloading of data from electronic medical record systems have highlighted in several studies that I have read as critical success factors in patient acceptance of personal health record and related consumer health applications.
My friend and colleague Dr. Kevin Leonard has, for the past few years, been passionately advocating greater patient involvement in their care along with greater electronic access to their personal health information. While Kevin’s Patient Destiny initiative seemingly focuses on what he calls “One Patient, One Record”, I think that the essence of Patient Destiny has to do with transforming our healthcare system through greater patient engagement in all aspects of healthcare delivery, from policy through to medical practice.
Patient engagement can take many forms. This morning, I read about what seems to a novel approach to patient engagement. The Health Mentors Program at Dalhousie University in Halifax, Nova Scotia, provides an opportunity for approximately 550 first-year students from a variety of healthcare programs to gain a better understanding of the daily challenges of living with a chronic condition from adult volunteers. Students enrolled in the program meet with the patient mentors four times per year and hear first hand from these mentors about their experiences navigating the health system.
Dr. Laurie Collins, faculty director for the Health Mentors Program, notes that the volunteers are eager to get involved:
“People with chronic illness don’t really get the care they’d like – in many cases they’re frustrated and dissatisfied … They really feel they’re contributing to the development of a better health care system.”
About a month ago I wrote a blog post about the “One Patient, One Record” symposium organized by Dr. Kevin Leonard. Well, tomorrow is the big day and I am hoping to experiment with live blogging and tweeting from the conference. Not sure how the technology will all work but I am going to give it a try. You check out more details about this symposium and other of Dr. Leonard’s initiatives to get patients more engaged in their care at http://www.patientdestiny.com
Although I did not attend HIMSS in person this year I have been actively following the event on twitter, blogs, and various video sites. Based on what I have read and heard, I think that the following summary of the key themes emerging from HIMSS neatly sums things up:
Dr. Halamka is highly respected in the US healthcare IT and medical community. He plays an active role in the meaningful use debate as Chair of the US Healthcare Information Technology Standards Panel (HITSP). Of particular note in Dr. Halamka’s summar:
- “Cloud computing, Software as a Service and ASP models are popular tactics to accelerate EHR rollouts”
- “Self service kiosks for patient identification and self-registration are now mainstream. Just as we print our airline boarding passes, we can now use credit cards or biometrics to check into ambulatory care appointments and automatically settle all co-pay balances.”
- “PHRs and patient engagement are becoming more mainstream. Google and Microsoft continue to innovate in the non-tethered PHR marketplace.”
Based on what I read and heard, there was quite the buzz at HIMSS this year. I only wish that we could generate the same level of enthusiasm for healthcare IT (see, I’m saying eHealth less and less) in Canada. *sigh*