Tag Archives: patient engagement

What is Best for the Patient?

First published in Healthcare Information and Communications Canada:

A little over two years ago I took a left hand turn in my career path when I joined a regional EHR program as their Project Manager. Having written and spoken about interoperability and digital health solutions, I wanted to “put my money where my mouth is” so to speak and devote my time and talent to realizing the vision that I so often advocated.

I am fortunate to be working with a dedicated group of people committed to making a difference for patients in Ontario. Whenever we are faced with a di cult situation or are choosing from what appear to be similar options, at least one member of the team always asks, “What is best for the patient?”

My wife is one of these patients.

Diagnosed about ten years ago with a chronic illness, Tracy recently embarked on a new journey to speak for those whose voices are not quite loud enough and to provide perspective to those who want to listen.

A talented writer, Tracy uses her blog to share her own experiences engaging the health system, offers insights on the view from the other end of the stethoscope (or, of interest to readers of this magazine, healthcare apps) and, from time to time, advocates for change.

Tracy has discovered, to her dismay, what others such as the McMaster Health Forum have observed: the patient is often not at the centre of care.

In a brief prepared to stimulate discussions by a citizen panel on strengthening care for people with chronic diseases in Ontario, the McMaster Health Forum notes:

“Health professionals don’t always work together to get people the care they need, despite this being important for improving patients’ outcomes.”

A briefing note prepared by the Institute for Clinical Evaluative Sciences (ICES) on variations in quality indicators across Ontario physician networks offers a similar perspective:

“Patients living with chronic disease have the best outcomes when they are treated throughout the progression of their disease, in a coordinated manner that engages all medical professionals involved in their care. However, in Ontario there has been a history of fragmentation of chronic disease care, leading to serious gaps.”

According to the McMaster Health Forum brief, access to their own health information can “help patients set goals for their health, manage their own care and better engage in decisions about their care with their providers.”

Unfortunately, the same brief also notes that there is “a lack of electronic health records that put all of a patient’s health information in one place” and, as a result, “patients also do not typically have access to their health information.”

As Internet pioneers and founding executives of several Internet start-ups (different companies before we met), Tracy and I both witnessed the creativity and innovation that was unleashed when entrepreneurs were given access to a platform (in this case, the Internet) on which to construct new applications and services

The banks recognize this same potential and are creating similar environments

to encourage innovation in financial services. Scotia Bank, for example, created the Digital Factory which they describe as a “hub for creation and incubation of new and partner-led ideas to deliver game-changing solutions for Scotiabank customers.”

Can the health system take a similar approach to encourage the development of applications and services to manage their own care and more e ectively engage their healthcare providers? Mohawk College and eHealth Ontario think so. They have partnered to create the eHealth Ontario Innovation Lab, an online, open provincial EHR platform that allows testing of digital health solutions in a virtual EHR environment.

Operationally and physically isolated from eHealth Ontario’s production environments, the Innovation Lab’s Virtual Lab Environment contains copies of eHealth Ontario EHR test environment assets and a fabricated, integrated EHR data set. These assets currently include the Ontario provincial client registry and the Ontario Lab Information System (OLIS), with the Ontario provider registry soon to be available.

Whether the eHealth Ontario Innovation Lab generates new and useful digital health solutions remains to be seen. At the very least, it provides developers with access to the provincial systems in which patient information is stored, information that patients can use to manage their own care and more effectively engage healthcare providers.

I recently shared Tracy’s blog with a friend of mine. He commented, with a wry smile, that we must have very interesting dinnertime conversations. We do. She inspires me each and every day to do what is best for the patient.

You can at themadnessmaven.ca

Healthcare Consumerism: Patient expectations are changing

You are in a maze of twisty little passages, all alike. The task seemed simple enough: book an appointment for a follow-up visit with an orthopedic surgeon in Ottawa based on a referral from an orthopedic surgeon in Toronto. Yet, by my third call, I was beginning to feel like I was in one of those subterranean mazes that characterized Colossal Cave Adventure, one of the first computer games I ever played. While logic and common sense finally prevailed and I was able to book an appointment, the experience reinforced my contention that patients are also consumers and will increasingly demand the same level of service from their healthcare providers that they do of other service providers.

Check out the rest the rest of my article at Technology for Doctors.

Mike

 

Patient or healthcare consumer? Is there a difference?

Where am I? Why am I having trouble focusing? Oh, wait a minute … that’s my hand … at least, I think that’s my hand. Why does it appear to be moving in slow motion and leaving a blurry trail in its wake? Oh, hang on, there’s my foot. It’s in a cast! Oh, now I remember … it’s all coming back to me now.

Check out the rest of my article at Technology for Doctors.

Mike

Happy New Year and an Apology

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.

Mike

“Consumer” or “Patient” – Roles We Play

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.

Mike

 

Using IT to Encourage Patient Engagement

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.

Mike

 

Patient Mentors – A Novel Approach to Patient Engagement

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.”

Mike