Health and Medical News and Resources

General interest items edited by Janice Flahiff

Patient Engagement: Overused Sound Bite or Transformative Opportunity? ‹ Reader — WordPress.com

Patient Engagement: Overused Sound Bite or Transformative Opportunity?

From the 31 March 2015 post at The C Health Blog


Criteria for Stage 3 of meaningful use of EHRs were released recently and there is lots of controversy, as would have been predicted. One set of recommendations that is raising eyebrows is around patient engagement.

The recommendations include three measures of engagement, and providers would have to report on all three of them, but successfully meet thresholds on two.

  1. Following on the Stage 2 measure of getting patients to view, download, and transmit their personal health data, the Office of the National Coordinator (ONC) has proposed an increase from five to 25 percent.
  2. The second measure requires that more than 35 percent of all patients seen by the provider or discharged from the hospital receive a secure message using the electronic health record’s (EHR) electronic messaging function or in response to a secure message sent by the patient (or the patient’s authorized representative).
  3. The third measure calls for more than 15 percent of patients to contribute patient-generated health data or data from a non-clinical setting, to the EHR.

This is all a mouthful, and it’s striking and a bit misguided from two perspectives. First, this requires health care providers to present material to or interact with patients electronically in the name of patient engagement. But it is really mostly about shoveling uninspiring material at our patients that is redolent of highly technical jargon with minimal context, with the belief that it is somehow good for patients to be engaged in this way. The intent is admirable, but the execution flawed. In addition, it is not surprising that many providers have had challenges meeting the Stage 2 requirement that five percent of patients download their medical records. It seems akin to saying that this week’s book club selection is the text for advanced graduate study of quantum mechanics — and then wondering why no one shows up for the meeting.

Some define engagement in terms of how many times consumers or patients interact with informational websites or portals. Both insurers and providers do this. Once again, there is puzzlement over why consumers would choose to spend more time on sites such as BuzzFeed, Facebook and Yahoo, rather than intently study their health benefits or review their lab tests.

At Partners HealthCare Connected Health, our first generation interest in engagement came when we saw, reproducibly, that people who interact with connected health programs have consistently better health outcomes.

cHealth Blog_patient engagement_mobilePartners HealthCare Center for Connected Health's 2010 Progress Report, Forward Currents

This brings up two salient points: The first is how finely we can measure engagement using connected health.

……

July 22, 2015 Posted by | health care | , , , , , , , , , , | Leave a comment

NLM Director’s Comments Transcript Care Benefits from EHRs: 10/28/2013

English: MedlinePlus logo

English: MedlinePlus logo (Photo credit: Wikipedia)

 

From the 28 October 2013 Director’s Comments Blog

 

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what’s new this week in MedlinePlus.listen

Emergency room use and hospitalization rates for diabetes patients declined after a large California medical provider introduced an electronic health records system, finds a five year study recently published in the Journal of the American Medical Association.

The study of 170,000 Kaiser Permanente Northern California diabetes patients (from 2004-2009) found an average of 501 emergency department visits per 1000 patients declined to 490 after Kaiser’s clinics began to use an electronic health records system (EHR) for outpatient treatment.

The study found an average of 252 hospitalizations per 1000 diabetes patients declined to 238 per 1000 after Kaiser Permanente’s clinics used the health care provider’s EHR. The specific hospitalizations for ambulatory care-sensitive conditions also fell from a mean of 67 per 1000 to about 60 per 1000 diabetes patients after the use of an EHR for diabetes outpatient treatment.

The comparative, overall declines in emergency department visits and aforementioned hospitalizations among Kaiser Permanente’s diabetes patients were statistically significant, or did not occur by chance. There was no overall difference in the frequency of patient visits to a physician’s office after Kaiser’s clinics began to use the health system’s EHR.

The study’s nine authors estimate Kaiser’s cost savings from reduced emergency department and hospitalizations were about $158,478 per 1000 patients each year. Overall, they write (and we quote): ‘the estimated reductions in emergency department (ED) visits and hospitalizations that we identified for patients with diabetes may have potential to affect ED and hospitalization costs’ (end of quote).

The authors acknowledge future research needs to provide a more comprehensive assessment of the cost savings after the implementation of an EHR. They add the findings are limited to diabetes patients within one large health care provider (within one U.S. state) and may not be generalizable to other states and different medical systems. For example, the authors explain the reductions in emergency department use and reduced hospitalizations were not uniform among all of the 17 Kaiser Permanente clinics where the five year study was conducted.

On the other hand, the authors note the study is the most comprehensive to date about the impact of outpatient EHR use on adverse health outcomes. The authors explain they assessed diabetes patients in order to observe the impact of EHR use on an outpatient basis among adults with a chronic (or ongoing) medical condition over time.

The authors conclude (and we quote): ‘We extend the evidence of EHR-related improvements in care delivery by further describing statistically significant modest reductions in downstream adverse health outcomes measured by ED visits and hospitalizations’ (end of quote).

Meanwhile, MedlinePlus.gov’s personal health records health topic page provides information about the physician adoption of EHRs in the ‘statistics’ section. Information about the adoption of EHRs within residential care communities and office-based physicians also is provided within the same section.

A overview that explains how and why EHRs are implemented in medical centers is available in the ‘MedlinePlus Magazine’ section of MedlinePlus.gov’s personal health records health topic page.

A helpful explanation (from the National Institutes of Health) about how to protect the privacy and security of your health information is available in the ‘related issues’ section of MedlinePlus.gov’s personal health records health topic page.

MedlinePlus.gov’s personal health records health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about personal health records (and EHRs) as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s personal health records health health topic page, type ‘personal health records’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘personal health records (National Library of Medicine).’

 

Before I go, this reminder… MedlinePlus.gov is authoritative. It’s free. We do not accept advertising …and is written to help you.

To find MedlinePlus.gov, just type in ‘MedlinePlus.gov’ in any web browser, such as Firefox, Safari, Netscape, Chrome or Explorer. To find Mobile MedlinePlus.gov, just type ‘Mobile MedlinePlus’ in the same web browsers.

We encourage you to use MedlinePlus and please recommend it to your friends. MedlinePlus is available in English and Spanish. Some medical information is available in 43 other languages.

Your comments about this or any of our podcasts are always welcome. We welcome suggestions about future topics too!

Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

That’s NLMDirector (one word) @nlm.nih.gov

A written transcript of recent podcasts is available by typing ‘Director’s comments’ in the search box on MedlinePlus.gov’s home page.

The National Library of Medicine is one of 27 institutes and centers within the National Institutes of Health. The National Institutes of Health is part of the U.S. Department of Health and Human Services.

A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.

 

 

 

 

November 3, 2013 Posted by | Consumer Health, health care | , , , , , , , , , | Leave a comment

   

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