For those of you who are connected with us on Twitter (@springerpub), this article might look familiar to you. After reading through some interesting ideas for how electronic health records (EHR) could incorporate features from social media (in this case, Facebook), we tweeted this article out to our audience and ended up getting in touch with the article’s author, Software Advice medical analyst Melissa McCormack. As Melissa researches and advises businesses on EHR software (you can check out some reviews of these systems here), we thought she might have more to say about how Facebook’s Timeline could be replicated in medical records to improve patient care. See our conversation with her below.
How would a more patient-centric EHR help drive patient engagement? Do you think this would only drive engagement in certain demographics, or do you see this improving among patients across the board?
One doctor I spoke with recently made a great point about “patient engagement”—it’s something of a misnomer. It should really just be called “engagement,” because it’s not just something the patient does; it requires participation from the provider, too. In today’s medical system, providers often don’t give patients the tools they need to feel comfortable engaging in their care. But a medical record like the one I’m describing would give patients access to their own data and partial ownership of that data. The design would encourage participation from both the patient and provider, and each party would be notified about the other’s participation. Patients would not only have access to key information but would also be put in a position of empowerment in their medical “story.”
Some demographics such as the young and the tech-savvy might be disproportionately impacted, but I don’t think there’s any group that wouldn’t benefit from more accessible, transparent information about their health care.
What about doctors? Which features of the "Facebook-like EHR" could they take advantage of to minimize their patients' risk of hospitalization?
One important feature is the ability to coordinate with other providers using a single, comprehensive medical record. Not only would the primary care physician have access to exactly the same data as the specialist, but the system would alert each physician when another makes updates or when a patient visits (or misses an appointment with) a referred doctor. This coordination would help all the members of a care team — all physicians as well as the patient — stay on the same page, and stay on top of managing a care plan that gets patients well.
Can you explain some of the roadblocks preventing a more collaborative, patient-centric medical record from being created? Are there risks or concerns associated?
One of the biggest roadblocks is the state of the EHR market today. The HITECH Act (which incentivizes doctors to adopt EHR technology) caused demand for EHRs to skyrocket overnight, and hundreds of EHR vendors sprung up quickly to address that demand. What we have today is a fragmented system where medical records don’t usually interoperate very well, yet physicians are committed to moving forward with that system to qualify for HITECH dollars. Revamping that system would be a big undertaking.
Another concern on the clinical side is whether patients should, in fact, have access to all of their health records. Some doctors aren’t comfortable with that level of transparency. Along those lines, another concern is the fact that not all patients are in a position to access digital records — for example, those without computers or regular Internet access.
Which "Facebook-like EHR" feature would have the biggest impact on preventing readmissions? Is this a feature that some medical record vendors already offer?
Patient notifications and alerts would help tremendously with avoiding readmissions. These features would be especially helpful in elderly patients with chronic conditions who rely, at least to some extent, on family members or professional caregivers to help them with their care. A “Facebook-like” medical record would allow patients to give their caregivers access to some or all of their medical record. Caregivers could monitor newly-prescribed medications and ensure patients are taking them on schedule; they would receive reminders about upcoming appointments and help ensure patients get to them, and they would also receive alerts about new test results or other important medical information from a provider.
Some of today’s forward-thinking EHRs are already providing notification and alert-type features for patients. But a hypothetical “Facebook-like record” would be able to integrate similar features for caregivers and would automate a lot of the work for both physicians and patients.