The Missing Link

Guest Post By: Bill Cast, MD of Fort Wayne Indiana

A retired surgeon and current health IT executive, Bill is a self-proclaimed early adopter of electronic health records (EHR), but found its impact on patient health limited until he (and others) discovered “the missing link,” and eliminated it…

When our practice began using an EHR some 14 years ago, and still today, the missing person at the electronic table was most often the patient. With the arrival and increasing adoption of personal health records (PHR), that is changing, and none too soon.

The PHR is the patient’s memory, all in one place, and it is their oral history transcribed with the same value and drawbacks as if it were spoken—more accurate actually since it is cumulative with less opportunity to forget an issue of importance.  It acts as a checklist for physicians’ histories.

Portable, patient-managed PHRs are valuable and easy to use in an environment where physicians are ready—both within their workflow habits and digitally—to accept patient PHR data. Doctors can bring in electronic PHR data  and find it of great value in maintaining drug lists, confirming orderly past histories, accessing treatment plans, sending data to patients and communicating with patients and their families. We hear patients’ frustrations when physicians will not use PHR information, and most often this complaint comes from critically important groups: those with chronic illnesses, those who care for other family members, and those who wish to engage with physicians to understand their own care.  It is true that most citizens need a PHR only in reserve—for emergencies or orderly data storage but not used week by week.  But since less than 10 percent of patients spend over two-thirds of healthcare dollars, communicating with those patients is critical.

Very soon, not to be digital will bring two kinds of penalties. While fee reductions await those who delay too long, the more lingering penalty may be to reputation. As meaningful use in its first stages requires patient interaction, and as patients find more practices able to eliminate the hated clipboard, physicians who lag behind will be seen as less friendly or out of date. Patients want to believe that their physicians have all the information needed and that they are able to communicate and interact with them and with other treating physicians. That truth or absence will become increasingly visible.  If your practice, clinic or hospital is lagging behind when it comes to electronic patient engagement, I urge you to take action and become an imPatient provider.