• How can EHRs engage patients by integrating medical devices?

    Author | Date May 20, 2013
    Patients with diseases such as diabetes produce valuable data regularly, some of which can prevent serious medical events from escalating if providers are able to intervene more quickly and directly. For these patients, medical device integration and patient engagement are seemingly one and the same. However, prior to the adoption of EHR systems and medical device integration, the flow of patient data for those dealing with a chronic disease was limited to in-person meetings between providers and patients during intermittent clinical encounters.
    “Traditionally when I see a patient, I’ll see them and not again until the next three to six months,” says David Harlan, MD, Director of the Diabetes Center of Excellence at UMass Memorial Medical Center in Worcester, Mass. “Between those visits, it’s a wasteland. There’s just no communication.”
    While the aim of future stages of the EHR Incentive Programs is to increase patient engagement, numerous patients with chronic diseases stand to benefit from increased provider-patient interaction immediately. This is the reality that has motivated Harlan and the Diabetes Center to put electronic, internet-based systems in place to bridge the gap between providers and patients as well as to minimize the duration between appointments.
    “We make it easy, as easy as can be, for patients to plug any of the available blood glucose meters into any internet-linked computer system and all of their diabetes-relevant numbers are uploaded into a system we can see and they can see,” explains Harlan of My Care Team, the web-based system provided by Allscripts used at the center. “We’re working to have a diabetes scorecard that shows each patient where they fall in metrics we know influence their outcome: cholesterol, blood pressure, weight, vaccines, eye appointments, etc. Whenever they log on to that site, they can see where they should be focusing their attention to achieve their health goals.”
    Integrating medical devices and providing patients with the ability to communicate with providers in real time carries with the challenge of ensuring data integrity, which the Diabetes Center has handled in a straightforward fashion. “In My Care Team, there are different levels of data integrity. If it comes directly off of the meter, it’s indicated in the chart that way. If the patient has overwritten it or entered it themselves, it’s indicated that the patient entered it as such in the record, ” Harlan reveals.
    While the patient is likely to prove the ultimate beneficiary of medical device integration into the EHR system, providers benefit in two key ways:
    For the specialists like us, we really embrace the data because those are our tools of the trade. We need to see it. If we can employ the patients into the team by having them upload their meters as opposed to bringing in their meters where our staff have to do it, not only is it a more cost-effective way of gathering that data but it also kind of sneakily incorporates patients into the team where they need to be anyway. If patients are doing that, they’re looking at the data.
    Patient engagement requires two things from patients. The first involves getting these individuals to communicate with their providers. The second and perhaps more important of the two is for patients to assume a primary role in managing their own health by interacting with not only providers but also their electronic medical information.
    As chronic disease management proves, patients and provider engagement with them make all the difference in leading to either positive or negative health outcomes, more so than anything a care team can possibly do. “If you’re engaged with us your support team and engaged in attacking your disease, you’ll win. If you’re not, there’s nothing the rest of us can do that will help you,” says Harlan.
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