Tom is imPatient…
New Haven, IN
A retired factory worker, Tom is defying the stereotypes of his demographic by actively engaging with electronic health management tools…
Tom Diehl retired “early” at age 65, not out of desire but due to a growing list of health concerns. Atrial fibrillation. Kidney problems. Mitral valve cord repair and triple bypass surgery in late 2009, and two years later, a pacemaker to help regulate his arrhythmia.
Today, he’s added another technology tool to the mix – an electronic personal health record he uses to track and monitor his own health.
Early signs of trouble ahead
Tom was 6’4” and 290 pounds the day he started high school. He was also already suffering from hypertension. “I always had trouble passing the physical for sports because of my blood pressure. By today’s standards, and even by the standards 50-plus years ago, I would have been considered obese, but I never felt that way. I was just a big farm kid,” he says.
For Tom, like so many others, weight management became a lifelong challenge.
“Growing up, we were all exposed to cigarettes and alcohol, and I knew smoking and drinking and even eating could shorten my life. I had a lot of things I wanted to do, and I knew the one I enjoyed most was eating, so I gave up the other two,” Tom says.
Life goes on
As a young and then not-so-young adult, Tom navigated through life while his health rode quietly along in the back seat. Now married more than 42 years, Tom and his wife raised six children and enjoyed active participation in church. Tom worked 30 years in a rubber factory, and the last 16 years selling cars. His wife was a nurse.
Typical of the times, Tom took care of the family finances; his wife served as the family medical director. “It used to be if someone asked me what kind of medicine I take, I’d just look at her. Not only could I not pronounce it, I wouldn’t even know what it was,” Tom remembers.
But all that has changed.
In 2011, Tom was invited to participate in a pilot program available through Parkview Physicians Group – Cardiology (PPCG). Funded through a grant from the Office of the National Coordinator of Health IT, the program provided patients like Tom with an electronic personal health record they would use to compile, organize and share health information with their healthcare providers. The program goals: improved communication between patients and providers, and improved outcomes as patients began taking a more active role in their own health.
“When I heard about the program, my first reaction was ‘Well, if it could benefit someone else, I would do it’. That was my main motivation,” Tom says. “But I also saw how taking control over my own health would be beneficial. For years I had been encouraged to weigh myself everyday and take my vitals. Now I had a way to log all that information without writing it on a piece of paper on the wall and then having to wonder where the grandchildren put it.”
Participants in the program (all of whom had recently undergone cardiac bypass or stent surgeries) were given NoMoreClipboard personal health record (PHR) accounts, pre-populated with data from PPGC’s electronic medical record system. The patients had baseline lab testing to establish weight, blood pressure, lipid and HbA1c levels. They also completed surveys to measure patient engagement and comfort using technology. Finally, participants were trained on how to use their PHRs.
PPCG repeated the survey and lab tests at six months and 12 months, measuring changes in patient behavior and health status.
Overcoming the first challenge: confidence
When it came to using the computer, lack of confidence was not an issue for Tom, but he knew it would be for others in his generation.
He explains, “People that are my age or a little older, they don’t navigate the internet much or use computers. It’s just not part of their lives.”
While his career in auto sales required Tom to use computers to research and store information, he used his home computer mainly for emailing and keeping in touch with family and friends. In fact, he says his biggest contribution to the family’s move into the digital age back in 1989 was picking the family’s email address – therealdiehl – one they still use today.
Using the computer to help with his health seemed like a good idea, especially since it was something he could do during his “recliner time” – required periods of rest with his feet elevated.
He recognizes the irony – that people his kids’ age don’3t see health issues as a big part of their lives today, but they use computers for everything. The people who do have ongoing health issues have little training with online tools, and they’re intimidated. But Tom is optimistic and says that with an hour of training, he believes many people would know enough to begin using a PHR.
Tom began logging into his PHR to track daily vitals – his blood pressure, weight and pulse. He entered his allergies and a list of his medications, plus a list of all the doctors he sees. Over time, he started working on his family medical history, immunizations and a list of the procedures he’d had done, and he found himself feeling more involved than ever in his own health.
He says, “There is so much you can put in this system so people don’t have to be so naive or ignorant. If they have any kind of health challenge, they can keep all the information organized here. Today, when I go to the doctor’s office, I can take a print out from my PHR, go down the list and confirm and recognize things. It’s allowed me to educate myself and report information from my doctor that I documented so they can see where I struggled.”
Now that Tom’s actively using his PHR, he wishes more of his doctors would get on board. His NoMoreClipboard account is designed to interface with whatever system a doctor is using, but he’s run into trouble convincing the front desk at several practices that they can share information electronically.
“My PHR lets me fill out all the pre-registration information I need for an appointment, but when I try to submit it to a doctor who’s not in the Parkview system, they won’t take it,” Tom says.
Another frustration for Tom, because he’s an early adopter of this technology, is that the medical community doesn’t automatically push electronic information to his account.yet. “I wish I wouldn’t have to remember to ask them to send a summary of my appointment or my lab results,” he says.
Finally, convinced that others would experience the same value that he has, Tom wishes people would just give it a try. “I probably know 30-40 families right now and I bet at least ten of them could do everything I’m doing with my PHR,” Tom says. “I’ve worked with the PHR now for almost two years and it really does help you take control of your own health.”