By Neeta Goel, M.D., Medical Director, Quality & Population Health, Inova Health System
Engaging patients in their care is key to improving population health outcomes. One of the ways patients can be better engaged in improving their health is by receiving access to timely and meaningful health care data. Patients who have access to their health information are able to follow their treatment plan more consistently resulting in better management of chronic conditions such as diabetes, heart failure, asthma and chronic obstructive pulmonary disease. Ultimately, this helps reduce the total cost of care by decreasing the number of emergency department visits and hospitals admissions associated with poorly controlled chronic diseases.
The advances in healthcare information technology provide healthcare organizations and physicians many opportunities to share patients’ health care data electronically in real-time and on-demand. According to a recent survey by American Hospital Association, 93% of hospitals and health systems enable patients to view information from their health record online, an increase from 27 percent in 2012. For patients to benefit from having health care information at their fingertips, data needs to be shared in a user-friendly format and should be interactive. Most electronic health records now have the provision of an interactive patient care portal that patients can use to view test results, request medication refills, and ask questions about health concerns in between appointments with their clinicians. These activities support the self-management of health conditions. Frequent communications between patients and their healthcare teams help patients develop a trusting relationship with their physicians making them more likely to follow the treatment and wellness advice from their health care team. With enhanced electronic communications, patients have been shown to seek advice from their physicians’ office before visiting the emergency room for non-emergent conditions. Additionally, the ability to make appointments with physicians electronically makes it more convenient for patients to use the less expensive outpatient places of care for non-emergent medical concerns.
Technology allows for two-way exchange of data, empowering patients to further contribute towards their health by sharing vital information with their physicians. Some examples of data sharing from patients include sending home blood pressure and blood sugar logs to physicians. This information is critical for physicians to monitor chronic conditions such as hypertension and diabetes. By having information about home blood pressure and blood sugar readings in between clinic visits, physicians are able to make treatment decisions sooner, allowing for better management of uncontrolled chronic conditions, and enhanced quality of life for patients. In addition to patient-reported data, information can also be shared with the healthcare team by using a mobile health application (app) or a medical device that can be connected to the patient portal. The app can be utilized to monitor patients’ vital signs and other essential health parameters to provide real-time information to healthcare teams. There are numerous health apps and medical devices that support self-management of patients’ health conditions. The health apps used by patients must be reviewed and cleared by the Food and Drug Administration (FDA). The FDA applies the same risk-based approach to evaluate health apps as used to assure the safety and effectiveness of other medical devices, to ensure that apps provide meaningful information to patients and their healthcare team. Additionally, by using a patient care portal, patients can proactively monitor the due dates for preventive tests and procedures such as cancer screenings and immunizations. Patient can share records of services received outside of the patient-centered medical home with primary care physicians, to help keep their medical charts up to date and support the physicians in meeting the quality metrics targets under various value-based programs.
Ultimately, this helps reduce the total cost of care by decreasing the number of emergency department visits and hospitals admissions associated with poorly controlled chronic diseases.
Many hospitals now allow patients to view entire progress notes from their physicians via a patient portal, however the percentage of organizations sharing the full progress notes is still small. Physicians worry that the medical terminology used in progress notes may prompt questions from patients creating extra work for them in responding to the questions. There is also sensitivity around patients seeing specific terms used to describe medical conditions (e.g. obese or smoker). The organizations that have taken steps to allow the release of full progress notes from physicians have benefitted from positive patient engagement. The information available in the notes helps patients review treatment instructions after a visit, improve their knowledge of how to manage their health conditions and share information as needed with the other health care providers involved in their care. Information present in the patient portals are accessible from anywhere in the world, supporting patients in their care while away from home.
In essence, by having access to their health care data, patients can engage in health improvement activities and make shared decisions with the healthcare team involved in their care to live a healthier life. Ultimately, an engaged patient is critical to promoting the transition towards value-based healthcare.