Monday, November 22, 2010

Paper Free Healthcare

Paper Free Healthcare (5:06)
A powerful video highlighting problems caused by paper records for physicians and patients and promotes electronic health records for safety, organization, and efficiency. Created by a company specializing in medical solutions, including EHR software (Allscripts).

Advantages of Electronic Health Records

EHR doesn't just help on the local level, they can also help with national security! See how EHR can help during natural disasters, help to fix medical mistakes, and give out public notification of disease outbreaks in Advantages of Electronic Health Records.

Sunday, November 21, 2010

Becoming a Patient Advocate for Yourself

The STAT blog recently sat down with Genevieve T of to talk about patient advocacy and how you can advocate for you own best care. She shares with us 9 great strategies to keep in mind and how you can stay on top of your own healthcare.
  1. Don’t Freak Out. Many times doctors order tests to rule out possibilities. Just because your doctor ordered a test that may indicate disease does not mean you have it. Wait until the results are in and you have discussed your options with your doctor.
  1. Seek out reliable, credible information. If you choose to research your symptoms or diagnosis online, make sure it is from a credible source. There are many websites online claiming expert knowledge on medical information. Scrutinize where each site gets its information from. Credible resources include:
Database of medical research documents: PubMed
Other websites that may offer credible information are national foundations of specific diseases. For instance, the American Diabetes Association provides excellent information on Diabetes prevention, diagnosis, management and care.
  1. Make sure you and your doctor are on the same page. Do you have a productive, open line of communication with your doctor? Are you able to ask your doctor questions? Do you both have the same goals for your health and treatments? If you find 
    yourself answering no to any of these questions, you may want to bring up your concerns with your doctor in order to open up a new line of communication.
  1. Not all doctor-patient relationships are compatible, and that’s okay to admit. Do not limit yourself to one doctor alone. It may be possible that there is another doctor you would be more compatible with. You shouldn’t continue seeing a doctor you are not satisfied with merely out of guilt. If you switch doctors you shouldn’t feel like you are “cheating” on your old doctor.
  1. Doctors are human beings too. Doctors are constantly learning on a daily basis, even if they’ve been practicing medicine for over twenty years. And even the best doctors sometimes make mistakes. They work extremely long hours and see many patients each week. Bottom line: The squeaky wheel gets the grease. If you continue to feel ill, follow up with your doctor until your questions and concerns are answered and resolved.
  1. Keep track of your health. Often times we have address books to keep track of important addresses, calendars to keep track of business meetings, family events, and soccer games, diaries or journals describing daily happenings, and To-Do lists to remind ourselves of the next thing to take care of. What if you kept track of your body the same way you do the rest of your life? While EHRs can certainly help you do this, it is important to listen to your body, notice changes, and write down symptoms when they occur so that when you talk with your doctor next visit you will remember what happened and when. Your doctor can only be as good as the information you provide him or her.
  1. Know that your doctor is not a magician. Make sure you take care of yourself and follow treatment plans. Your doctor cannot help you if you cannot help yourself. There is no magic wand your doctor can wave over you next visit to resolve all the damage you’ve caused to your body when you did not follow treatments prescribed. And there is no magic pill you can take to fix yourself overnight. Good health is a life long job and you must take responsibility do to your part to keep that job going for as long as you can.
  1. Look into having a support system. Many times support groups online can be an invaluable way to relieve stress by venting to those who most understand your situation, while also swapping ideas and information with fellow patients. Also, discuss your situation with your friends, family, doctor, and pharmacy. Are there times in which you will need rides to medical procedures? Do your friends and family know what needs to be done if your health problem should present an emergency situation? Do you need a medic alert bracelet in case you were to have a health emergency around strangers? Do you have a number on hand you can call if you have questions about your prescriptions? Even if you don’t think you have a serious health problem, do you know where the closest hospital is?
  1. What is your goal next visit? Do you know what you hope to accomplish at your next doctor’s visit? Is it a simple annual physical? Is this a follow up visit to a recent emergency health event? Do you have new information to give your doctor regarding family health history? Are you trying to find an explanation for a recent cough or pain? Is the medication you’re taking not working to meet your needs? Do you have questions or concerns? What is on your mind exactly? Make sure you are very clear about this before you go to your next doctor’s visit. If possible jot down any questions, concerns, or new information you may have and take that with you to your appointment.

Breaking the Nostaliga Habit

Imagine that you’re in an exam room waiting for your doctor. The year is 1961. What do you suppose happens when that doctor walks thorough that door, clipboard and file in hand?

Your answer is probably going to depend largely on your age. If you’ve managed to accumulate enough years on this planet, it’s possible that you remember being in a doctor’s office in 1961. Maybe you can even think of a specific doctor, though maybe the specifics of any one particular visit are a bit hazy over time. You might think fondly on a particular time when things, including doctors’ visits, seemed to move at a more reasonable pace. If you
’re in an age bracket that doesn’t remember a time without video games, however, your ideas about what doctors were like in 1961 are probably just a bit different. The doctor is just the conduit through which you can access the tests that will give you the results and expectant diagnosis. A doctor from a previous generation simply isn’t going to have as much knowledge access as a current one. If you fall into that generation between these two ends of the age spectrum, in that age bracket we call the Baby Boomers, you probably picture that 1961 doctor as a kindly old man in a crisp white lab coat. This is the sort of doctor who would understand and care about you personally. You imagine that the service and attention you would have gotten from the doctor would have been better.

The problem with all of these different visions of 1961 health care is that they don’t necessarily represent an "accurate" version of reality. Nor can we reasonably expect them to. Even those who remember walking into a doctor’s office in 1961 can’t reasonably be expected to legitimately remember that experience fifty years later. Doctors were't necessarily any more personal, or more invested in their patient healthcare in the 60s or really in any previous decade.

So when people are concerned that technology, like Electronic Health Records (EHR), is just going to get in the way of their care, that idea isn’t based on a real, honest assessment of past medical practices. Not to mention that all of it is going to be relative to personal experience. EHR are not going to make the doctor less interested in listening to patients and more concerned about the electronic data pad that gets brought around to each appointment. We often get anxious about technology getting in the way of one-on-one face-to-face interactions because we see it in our daily lives; or at least or perception of our daily lives. We catch up with old friends on Facebook rather than meet for coffee. We don’t stand around the water cooler at the office to discuss the previous night’s must-watch TV; we send forwarded interdepartmental emails instead. If we’re going to really understand the future of healthcare, we are going to have to let go of the idea that technology automatically distances us from each other as people.

That isn’t to say that technology is going to magically make things better either, but there are a lot of possibilities with EHR and the incorporation of technology tools into doctor-patient interactions. Let’s think about a new scenario, one where technology can enhance your healthcare experience.

Your doctor walks into the room were you’ve been waiting for a few minutes and greets you with a smile. The doctor then checks the iPad that she’s brought with her and says that it appears you’re here about a chesty cough that hasn’t gone away and asks you about other symptoms while listening to your lungs as you breathe in and out. She decides she wants an x-ray to rule out bronchitis, taps the screen on the iPad a few times and tells you that they are expecting you in radiology.

After you return from your x-ray you are shuffled into the waiting room again before your doctor joins you to go over your results. She brings up your x-ray on the iPad and says that according to the radiologist’s note everything looks okay, but you do need an antibiotic. She punches in a prescription, but frowns briefly and asks you about a drug allergy. Your record had prompted her to select a different prescription and wanted to confirm that you were indeed allergic as your records indicated. She prescribes you a new drug that you are unfamiliar with. She brings up a picture of the pills and use directions on the iPad and goes over your prescription with you.

She pulls out a stylus and signs the prescription electronically and lets you know that the pharmacy is completing your antibiotic order and that they assistant at the front desk is expecting you to schedule a follow-up visit in two weeks.

Nostalgia is often described as a wish for the past, a past that is more often than not idealized in our minds. In a way, nostalgia is a desire of a past that never really was. It’s a comforting feeling, particularly when we feel that our current frustrations are close to overwhelming. Nostalgia actually used to be classified as a disease, one that could send the new city dwellers of the industrial revolution back to family homes in the country to recuperate. We no longer thing of nostalgia as a disease to cure, but it is certainly something that we must overcome if we are going to greet the future of EHR head-on with a belief that we can ask for better healthcare. If we don’t, we just might have to face a reality where are worst fears are confirmed because we allowed things to happen just as we feared they would.

Saturday, November 20, 2010

Doc Digs Electronic Health Records

Doc Digs Electronic Health Records (2:20)
A doctor discusses the benefits of EHRs from a physician perspective, speaking to the pros for everyone involved.

Advantages of Computer-Based Medical Records

Still uncertain about the benefits of EHR? The good people at informatics-review have put together a brief but important list of the Advantages of Computer-Based Medical Records.

As Medical Charts Go Electronic, Rural Doctor Sees Healthy Change

A family doctor in rural Kansas says her switch to electronic records has greatly improved her productivity. Her patients also see an improvement in care. Read how in As Medical Charts Go Electronic, Rural Doctor Sees Healthy Change.

Why EHR? Personal Info On Paper

Summary: Wondering why the switch to EHR is necessary? For the same reasons that we no longer have other services on paper. Read on to find out more!

Imagine a bank where instead of using computers, everything reverted to pen and paper. As soon as you handed in your weekly paycheck (no direct deposit for this bank), the banker would write your account number, your social security number, your driver’s license number and other sensitive information onto a slip of paper that would be paper clipped to your money. For the next 24 hours that piece of paper would exchange hands between clerks, couriers, and any other person handling your transaction.

Certainly each of these people would be professionals, and it is safe to assume that the bank would do thorough background checks on each of them. But it would only take a moment for one to get curious and sneak a peek at your information, and they most likely would not get caught.

Once your money was deposited, imagine this computer-less bank then threw your information away, not bothering to shred it or the hundreds of other similar papers with equally sensitive material on them on the grounds that doing so would be too costly. Now imagine that in order to inform you that your money had been deposited properly, they send you not an email or a phone call but a postcard with that same sensitive information on display for anyone delivering the mail or snooping in your mailbox to see.

Would you be a customer at that bank?

Of course not and in fact such a bank would probably be sued into closing its doors for numerous privacy violations, and rightly so. Yet the sad fact is that many of our medical records are handled in the same way that the paperwork at the bank was handled in the scenario above. Medical records follow you around the hospital, are left in baskets outside your room. Several medical professionals per visit examine them, not to mention the technicians who do blood work, analyze x-rays and do other tests. Your records then ultimately sit on a shelf in a storage area until they are needed again or become too old and are thrown away, often without being properly shredded first. Worse still, instead of reporting your results to you directly, some hospitals have even been known to mail test results on postcards, allowing anyone who delivers the mail to know the results of whatever medical test you just had conducted.

It’s really impossible for us to know just how secure paper records are. If someone wants to take your paper records down and glance through them, a quick glance into your file could tell them your social security number, what medications you are taking, and any other information that your doctor has written into your chart, and odds are there will not be anyone around to catch them.

And even when human curiosity is not a factor, human error is. Files can be misplaced, misfiled, lost, or accidentally thrown out. In a paper system, the effectiveness of the paper work is only as good as the people running it, and humans can make mistakes at the end of a long shift.

This is why when you whip out your credit card to pay for your doctor’s visit, the clerk processes it not with pen and paper, but with a credit card swipe into a computer. Why, then, should your medical records be any different?

Interested in learning more about paper medical records and the security risks they pose? Please read A Day In the Life of a Medical Record to follow an actual paper record around.

A Day in the Life of a Medical Record

Still unsure that EHRs are going to be safe? Rest assured they are in fact much safer than the old paper system. A Day in the Life of a Medical Record is a detailed look at how the traditional paper medical records are often abused or mistreated, showing just how important the privacy and security benefits of electronic health records are, and why we need them over paper records.

Electronic Health Records: A Patient Perspective

Electronic Health Records: A Patient Perspective (3:55)
From the Health Science Channel

Friday, November 19, 2010

What is an EHR?

When I first heard the term “EHR” I was at a clinic and really confused. I wasn’t confused because of the EHR, I was confused because I’d been taking massive doses of cold medicine for 3 days and thought my head was about to float off without my body. So when a pleasantly smiley woman behind the clinic check-in counter mentioned an EHR I didn’t really hear her and thought that she was saying that I had to go to the ER. I must have looked absolutely panicked for a moment because she quickly assured me that it was perfectly safe and that my information was going to be just as secure as it was before. I nodded, still confused, but filled out the medical history paperwork provided for me. When I turned it in, I was promised that my EHR would be entered onto a secure server and that I would no longer need to fill out this information when I came to the hospital. At that point, I realized that I had not really understood what just happened and asked just what and EHR was.

I was happy to find out that it wasn’t anything bad.

EHR stands for Electronic Health Records, which are also sometimes called EMR, Electronic Medical Records, or even EPR, Electric Patient Records. All of those specifics are really for doctors and other medical professionals to work out, but to us patients it all just means the same thing. We’re going to have some changes to deal with and a uncertain transition period, but in the end it’s going to make our lives just a little bit easier, a little less stressful, and safer.

EHR, EMR, EPR, one way or the other, all of this alphabet soup is referring to the same thing; an individual computerized profile of a patient’s medical history. Right now, for the most part, our records sit around in folders in the basements of hospitals in rows and rows of paper. Compared to a record on a computer, a paper record is bulky and has to be organized and physically retrieved. Folders can be misplaced, lost or even damaged. The whole system runs without the efficiency of electronic communication that already characterizes how we do business, get our news and entertainment and communicate with loved ones in our daily lives. Maybe I’m just an idealist, but I for one feel like it’s pretty obvious that something as important as our health should get with the times and join us in the 21st century. EHR can help get us there.

That’s not to say that there isn’t legitimate concern and real resistance to change. For the doctors, nurses, and other hospital staff, an EHR mean learning a new system. Now I know that I’m not usually eager to learn a new way of doing things when I don’t feel like there’s a problem with my current performance. A lot of doctors feel the same way, and there’s bound to be resistance, but there also are plenty of doctors, nurses and other health care professionals out there who can really see the benefits to an EHR, like faster communication, clear records not plagued by infamous doctors’ scrawls, and computerized fail safes. Most other countries use sophisticated EHR systems to keep track of patient records and streamline the whole medical process. We’re realizing that in America we need to be willing to keep up with the times and realize that we can start asking our technology for help.

When you get right down to it an ERH is just information entered into a software program to create a medical profile that keeps track of medical histories, test results, diagnoses and medications. There is no one system our there; many companies currently working on developing the best possible EHR systems to meet the needs of hospitals, doctors and patients. EHR systems allow the doctors to create an account of individual records that keeps track of test results and diagnosis over the lifetime of the patient. This means that anyone in the hospital can take a look at your profile, or should I say EHR, and know why you are here and where you need to go next. The EHR system also builds in important security measures into the system so that your doctor will be instantly aware of any possible drug interactions or allergies to medication. An EHR is able to warm about problems before they become problems.

But all of this doesn’t really get to the heart of the issue. What does an EHR mean for you? It means that I’ll me you’ll have to fill out a big patient profile, which is annoying, but you won’t have to do it again. It means that there will problem be some bugs in the system while the hospital, doctors and nurses try to figure out all he kinks in the system. But it also means that your health care is going to become quicker, more streamlined and safer for you and your loved ones and that outweighs the inevitable growing pains of starting up a new system. As cheesy as it sounds, the future is now and we can’t really be content to hold onto a past that doesn’t really work all that great anyway.