Electronic Health Records

Adoption & Implementation News

Continuity of care redefined by meaningful use of EHR

By [email protected]

As the meaningful use of EHR continues to generate more structured data in clinics of all sizes from patient interactions, the portable nature of one’s care continues to be a challenge in the community of care. It’s more than just engaging a patient in a conversation about their health and documenting the appropriate information whether it’s in the office or remotely with myriad HIT resources.

It is still very much about the human interaction, as reflected in research from Dr. Kimberly A. Gudzune of Johns Hopkins University School of Medicine. While this is a complex conversation, the insights are important to consider with regard to the patient experience:

Gudzune, who has conducted other research on challenges faced by overweight patients in their interactions with the health care system, and her colleagues define doctor shopping as seeing three or more different primary care physicians over the course of 24 months. In their study of more than 20,700 patients in a BlueCross BlueShield claims database, the researchers found that 23 percent met the definition. The odds of doctor shopping increased by 19 percent for overweight patients and 37 percent for obese patients, as compared with normal-weight patients in the database. Four percent of patients saw five or more primary care doctors over two years, a practice more likely in obese and overweight patients as well.

Within the community, the clinic has been a source of both care and trust between physicians and patients. When I was a child, my primary care physician had an office attached to his home. Those patient experiences were far from the high-technology encounters that we know today, but they were founded on the basic principle of respect among all concerned in that experience regardless of their role in the clinic.

The EHR Incentive Programs and all of that data throughout the patient interaction are as much about leveraging human capital in the clinic as it is about efficiency of care. What’s more, with the abundance of information comes an even more complex dialogue.

Continuity of care has always been important for both physicians and patients. This is not a dialogue about some “ten steps to success” for either reconciling or preventing patient dissatisfaction with the healthcare experience. However, it is about a dialogue in the clinic.

As a patient advocate for a senior family member recently diagnosed with vascular cognitive impairment and Alzheimer’s disease, the sensitivity of the dialogue from patient data has never been closer to home. In this particular patient’s experience, the mention of the word “dementia” evokes an immediate response of denial from my family member. The cold, hard facts and insights are a reality of this abundance of EHR data, which puts even more emphasis on that old-fashioned principle of respect and delivery of the message with human interactions.

The portability of a patient’s electronic health data and insurance coverage will continue to be an invitation to take it elsewhere if the experience fails to meet expectations. We can all appreciate the value of continuity of care, from the shared respect to the ongoing insights and guidance between physician and patient. From individual health outcomes to population health to outcomes-based reimbursement models, an ongoing and coordinated dialogue between physicians and patients is critical to success for all concerned.

This is precisely why the EHR conversation must include the marriage of two forms of HIT in a continuous patient experience: Health Information Technology and Human Interaction Throughout.

 

Robert Green is the author of Community Healthcare: Finding a Common Ground with New Expectations in Healthcare. Through his physician client relationships, Bob has gained substantial insight regarding the daily challenges that medical professionals and their staffs face, such as regulatory issues, financial management, and clinical collaboration through the use of health IT. His process of making both interpersonal and purposeful connections within the organization results in improved employee performance and confidence and enhanced client experience.

 

 

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