The Rx is UX: A prescription for EHRs and patient engagement

During National Health Week, Oct. 2-6, Jane Sarasohn-Kahn, economist and blogger, reviewed the research published earlier this year. link the points between the implementation of the EHR (good news: it is almost universal in doctors' offices and hospitals) and patients who adopt their health information (not so often). What's missing: UX design and respect for people's life flows.

Most medical practices and hospitals in the United States have electronic health records installed. In a classic scenario Field of Dreams we digitized patients' medical records, but people do not ask for them or consult them en masse.

"How to make it easier for patients to request and manage their own data?", Request a report from the Office of the National Health Care Coordinator Improving the Medical Record Application Process for Patients – Highlights User Experience Search .

ONC was responsible for implementing the provisions of the HITECH Act, ensuring that health care providers met meaningful use criteria for the implementation of EHRs. and then received the financial incentives provided in the Act to comply with these provisions.

Now that the majority of health care providers in the United States have actually purchased and implemented EHRs, it remains the case for patients, health care consumers, and health care providers. To prevail. In my article on the Field of Dreams effect of the EHR, I pointed out the US General Accountability Office's research that explored the question of how does the Department of Health should evaluate the effectiveness of efforts to improve patient access. EHR.

The ONC team conducted in-depth interviews with 17 patients to understand their health staff and their personal workflows to access their personal health records. The research also looked at medical forms and information for 50 major health systems and US hospitals, and interviewed "insiders" – health stakeholders inside and outside of the US. ONC – to evaluate how patients request access to medical data. process.

Why is it so important that people have access to their medical records? By doing so, patients and caregivers can better manage and control their health and well-being, notes ONC, preventing repeated testing, managing clinical figures (such as blood pressure for the heart or glucose for diabetes) and sharing decisions with doctors. other clinicians – together, the process of patient engagement and health, which improves health outcomes for individuals and populations.

The general process of a patient asking for data about his health works like this, illustrated by the patient journey of Melissa and Ava Crawford, a mother and a toddler described in the report. ONC:

A patient / consumer makes an initial request
The consumer requests the registrations, which can be done via a paper authorization form (which is then completed and mailed or faxed to a supplier) or sent online via the portal. Sometimes a consumer has to write a letter to ask the supplier.
The consumer expects an answer, which the ONC calls "a bit of a black hole for consumers". This can last up to 30 days under the HIPAA law.
The health system receives and verifies the request and then verifies the identity and address of the patient.
Health systems then fill out the registration application, often a printed copy of the medical record that can be faxed or mailed, PDF files or a computer CD-ROM.

ONC conducted consumer path research throughout this process to identify opportunities to improve the patient's experience in applying for and receiving personal information about the health.

Populi Health Hot Spots: Most Americans see their doctors enter electronically into medical information, and most people say that access to all kinds of drugs is very important. Medical information is important. conducted in August 2016 . However, there are big gaps in the information available to American online patients, such as prescription drug history and lab results – two categories of information highly in demand by the population. And according to the perspective of patient consumption, one in two American adults said that he did not need to access his online health information, as he did. attests to the KFF survey chart.

How to bridge the gap between IT, providers and patients? The most effective patient engagement technologies are biometric measuring devices such as WiFi scales and glucometers, applications, text messages and wearables – with portals in the lead – according to the physicians and clinical leaders interviewed in a survey of the New England Journal of Medicine . ] published earlier this month.

The main benefit of engaging patients with these technologies is to support people in their efforts to be healthy and to provide feedback to providers about how patients are doing when they are not at the clinical.

My Friend and Contributor Michael Millenson wrote in BMJ in July that patient-centered care was no longer "sufficient". In this age of technological health care and growing patient consumption, three principles must underpin the relationship between patient and provider:

Shared information
Shared commitment
Shared responsibility.

Michael quotes Jay Katz in his book, The Silent World of Doctor and Patient who spoke 35 years ago of the concept of "caring guard". Jay explained that "the idea of ​​doctors" Aesculapian authority on the "replacement of patients by" mutual trust ".

It is not enough to build and offer a technology "intended" for patients and people to use for their health and health care. Trust underpins all health commitments, and must be designed and "cooked" in the supply. Today, this trust is based as much on the consumer retail experience (the last experience of someone in his daily life illustrated by Amazon at this time) that in a new health contract between providers and patients

This blog was published for the first time on Health Populi .

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