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The future of patient engagement, and the end of EHR as we know it… by 2025.

By: | Tags: , , , , , , , | Comments: 0 | September 21st, 2015

Recently we have read a multitude of papers on the failure of providers to connect with consumers, as they use their electronic healthcare records (EHR). There are reasons this is important. First, the quality of medical care, as we have discussed on these pages, doesn’t equate to more care is better care. Second, patients are demanding it. In an era when we have cars that drive themselves, the ability to open your car, turn on your engine and heat it with a remote, check if your front door is locked, see the temperature and humidity in your home from across the world and have a personal assistant on your phone; paper medical records should be extinct and the stove pipe electronic medical record, even in the cloud, should be obsolete. Not only should all EHRs connect and interconnect, but really, the Personal Wellness Electronic Record time has come. But this PWeR is not a single system or product, not even ours, it’s the fundamental shift of the use, ownership and control of the patient/consumers medical record by the patient and not the provider.

Meaningful Use Phase 2 (MU-2) mandates that by next year, in order for a provide to receive credit for meeting the mandated MU-2 requirement and not be discounted by the government for all government payments of care – approximately $1 trillion (USD) annually in payments – each provider must confirm that 5% of their patient population annually is communicating with the doctor via their EHR platform secure messaging feature. Furthermore, that 5% are accessing their medical record on the doctors EHR platform. MU-2 also requires providers to “transmit” a summary of care to a minimum of 10% of transition of care and referrals to other providers using Direct and Secure Email protocol. Wow! This is such a big deal that there are moves in congress to stop that mandate before it really kicks in. My best experience is with Medicare patients, so I imagine the challenges of elderly patients accessing many different systems with the average of 5 doctors they see each year. Denote, there could be 5 different EHR platforms they will have to access, learn, log in to and use annually. Imagine further as the new millennial generation, (the leading age around 34), start to see their adult doctors, and find they have more computer power and internet access, never mind technology, acumen in their hands than many doctors have in their entire office.

The issue will change, once patients control the information and doctors’ EHRs synchronize to the patients’ owned and controlled medical information. I predict in the near future we will see patients owning the EHR system, (maybe $49.99 a year), thereby making it free for doctors. The result: physicians forced to connect with patients, filling out paper work will be nonexistent, and every doctor will have the latest information. The generations that use Apple Pay, share cars, call for varied types of home delivery, stream music and watch Netflix, will NOT fill out paper forms time and time again as they interact with providers. Nor do they want to call and request an appointment, wait 50 minutes to see their provider while watching promotional videos, or day time soap operas on a doctor’s waiting room television. It will not happen.

Soon you will hear the term Consumer Mediated Exchange, with a suggestion to shorten to “C-ME” (see me). This C-ME term and idea has only recently come into use by experts in consumer centric care. It has some official standing as one of Office of National Coordinator’s (ONC) three approved forms of Health Information Exchange (HIE). I have seen very few HIEs work because too much information is being moved, and there isn’t a master patient file, per se. You will also hear about record banking, (more on this in a later blog).

Subsequently, there is the emerging Blue Button option. In a nut shell, the Blue Button allows you and any care giver you authorize to “download” your medical record to your computer. If you are part of Medicare, you can even download your past medical claims paid by Medicare .

The Center of Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS), notes on Blue Button:

Blue Button allows you to be in control of your healthcare and your family’s healthcare.

How can you use this information?

Having secure, electronic access to view and download your health records online means you can:

  • Share your information with people you trust, like your family doctor, specialists, and caregivers
  • Check your information to make sure it is correct and complete
  • Keep track of important health information like medications, vaccination records and test results
  • Have your medical history available if you are changing doctors or visiting a specialist
  • Find specific information about your health and healthcare when you need it, like in an emergency situation or when you are traveling out of town away from your usual healthcare providers
  • You can also plug your health information into mobile apps and other health tools. This can help you to stay in control of your health and your family’s health. It’s your health record and it’s about you so you should have it readily accessible when you need it

Why is this important?

The ability to electronically access and use your health records is critically important. Having this information available can:

  • Prevent someone from giving you the wrong medication
  • Avoid duplicate tests and procedures which can save you time, money, and even risks to your safety
  • Avoid costly delays in treatment by having important information at your fingertips
  • Make sure everyone caring for you or your family is on the same page
  • Being able to access your health records in an emergency situation can be lifesaving

Do we really really want all this information “deposited” or “downloaded” on our mobile phones, tablets, laptops or home computers? I think not.

We are now at EHR 2.1, and I for one, am completely sure that the current models are not working. We are not yet Empowering the Patients…Enabling Providers…Evolving the Science ™ but I also believe we soon will be.

– Noel J. Guillama, President

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