Monday, April 18, 2016

Allowing the Patient to Input Data into the Electronic Health Record


In the article Medicine 3.0 Panelists Dissect Patient-Generated Data, a group discussed the possibility of the patient inputting their own data into the Electronic Health Record. These included objective data like blood glucose measurements, virtual assistant type tasks, and changing the doctor-patient relationship paradigm from paternal (maternal) to dynamic.

With the multiple apps being constantly developed it is foreseeable that patients can arrive in the office or on skype with all the data necessary in advance for a focused practitioner-patient interaction. Rather than let’s get an EKG; the EKG is already completed. This can affect all the blood work dramatically. This will dramatically save the patients time and expense.
The virtual assistant tasks are even more intriguing. The patient can be offered a problem-specific template to be filled out that asks all the pertinent data. The provider can quickly review and affirm the accuracy and quality of the data. They can then ask problem specific questions to solidify the diagnosis. Can patients answer these questions? They do now but verbally. They can also be asked about the research they have already done on the internet. If they cannot fill out the forms than office staff can call in advance and verify items like problem lists, medications, and allergies.

The last concern was the patient-provider relationship change. The consumer wants timely accurate answers, compassion, and to get the provider’s expertise. The paradigm of rushing through multiple questions that usually have been already asked several times already could become a thoughtful interaction.

Two big unaddressed issues here are privacy and doctor time.  Privacy can no longer be secured, as evidenced by recent ransom-ware break-ns. The potential for hacking into a system goes along with having a system. Patients, at this point need to be informed that a facility will do everything possible to provide IT security, but cannot guarantee it.  It a patient types information into a system where security has been guaranteed, and it is hacked, the facility can wind up on the adverse side of a courtroom.

And then there is our old friend, time. How many doctors do you know (maybe you?) that really have the time to read all their patients’ blah-blah-blah.  True there is important information potentially there, but a downside will be that many patients will have free-hand at the keyboard, and take it.  Then what?

In conclusion: Look for major changes in workflow and data collection in the near future. This can be a positive development. Compliance may be improved and not understanding what the provider said may diminish.

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