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The Empowered Patient of the 21st Century – How Technology Enables Good Medical Practice

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This presentation will present a profile of empowered, e-patients, their expectations and challenges when confronted with medical issues and have to deal with the medical establishment, and the tools …

This presentation will present a profile of empowered, e-patients, their expectations and challenges when confronted with medical issues and have to deal with the medical establishment, and the tools that they use to communicate and collaborate with their health care providers. Patients are looking for compassionate, caring providers who are comfortable engaging with them in open two-way communication. They expect full information at the point of care so that in partnership with their providers they can make appropriate choices and good decisions

Today’s e-patient is used to constant communication delivered in sound bites from a variety of media. They use email to communicate with their colleagues and business associates, access various online networks and databases in order to connect with others, use a variety of health apps on their smartphones, and find needed information on the web. They are concerned with their health, but are typically confused and overwhelmed with the complexity of health care. The presentation will review the tools that e-patients and savvy providers use to provide the patient-centered care that we are all trying to achieve including: digital health records, email, patient portals, health information exchange, smartphones, online resources and telemedicine technology.

About the Speaker:
Nancy B. Finn is a health care journalist, thought leader and patient advocate focusing on patient empowerment and engagement with the deployment of digital communication technology. She is the author of “e-Patients Live Longer, the Complete Guide to Managing Health Care Using Technology”, published by iUniverse. She is one of the blog authors of e-patients.net published by the Society for Participatory Medicine, writes the health care blog www.healthcarebasicsinfo.com, and is the editor of Health Care Basics, a monthly e-newsletter. She is a contributing columnist and a reviewer for the Journal of Participatory Medicine and is sought after to write articles for health-related publications.

Published in: Health & Medicine, Business

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  • My objective today is to paint a portrait of the empowered patient By no means do I contend that the majority of patients today are empowered and engaged. However e-patients are growing in numbers and it is important for healthcare institutions and provider to understand their concerns, what drives them, the digital tools they are using to seek out health information and communicate with their providers; why communication and collaboration are so important; the challenges we face as we move toward a healthcare future that is dependent upon digital communication tools and the patient/provider partnership.
  • Today’s e-patient is bombarded from the moment they wake up until they close their eyes at night with sound bites coming from many different sources. In order to get through this tower of babel today’s e-patient goes to the web, talks with their providers and friends and stays abreast of what is going on in healthcare, because they are concerned about their health and the health of their family. So when they come up against a health issue they have high expectations that there will be good communication between them and those people taking care of them. Since health care is so complex there is great confusion about and people are overwhelmed with the complexity of the issues they are dealing with.
  • What is important to e-patients is that there is complete information about them, available to them and to all their providers; at the point of care; e-patients want compassionate safe care; they want open two-way communication with providers; they want to be helped with finding good resources to learn more about their health issues; they want clear medication instructions and discharge and follow up steps when they leave the doctor's office or the hospital.
  • There is a small percentage of vocal e-patients who are loudly advocating to have access to the data that is in their health record. They are in the minority but have set up the stage for a movement that will grow because as we discussed the smart patients of today want to know what is going on. There is a software platform that has been developed called open notes that Open Notes is an initiative* that invites patients to review their visit notes written by their doctors, nurses, or other clinicians. And there are some patients and clinicians that believe that everything piece of information that the clinician has the patient is entitled to as well. But there is a large group of patients who do not want to have access to this information because they want the doctor to make decisions for them and another larger group that is simply ambivalent. Also important is the question of what patients will do with their data once they have it. All of these issues are unsettled today…
  • Patients are challenged about how to navigate the health care system and particularly how to determine their cost of care. They are challenged in trying to cope during difficult times when there are many options for how to approach their care; they are challenged with information overload when they try to research medical issues on their own while at the same time challenged with too little information forthcoming from their providers who are always in a hurry. Providers are challenged with getting their patients to become engaged with their care and compliant with their instructions and medications that they prescribe. They are challenged by the concept of treating patients as full partners in their care and by the task of providing tools that will help empower their patients to do more for themselves. Providers are very challenged by the demands and restrictions of a healthcare system that does not allow them adequate time to deal with the complex issues that their patients present with and need assistance with.
  • Are beginning to see that patients want information and a part in health decisions; that they access and use health information with the digital tools a
  • 12 percent had emailed or texted their doctors. A Ruder Finn survey of more than 1,000 US adults found that 16 percent of smartphone and tablet users access health apps regularly. 64 percent of people taking health into their own hands, looking up some kind of health information online. 31 percent of those surveyed said they would be willing to pay for online consultations with their doctor, and 20 percent said they would be willing to communicate with their doctor online.
  • EHRs that can be accessed by all providers, by the patient, by nurses and therapists and even a rehab facility;include medication and allergies to prevent mistakes; Email to facilitate messaging; portals for secure communication, HIE to insure information is at the point of care; smartphone apps…Online resources, telemedicine, robotics
  • More patients get information from friends or their doctors than from the internet
  • The Web is perhaps the most used and most important tool of all.
  • I am an e-patients and was recently in the hospital for hip replacement surgery. I want to tell you my story because it reflects what is good and what needs to be addressed in our health care system. The most important element to me and should be for all patients is that full information is available at the point of care…that there is care coordination among all of the medical personnel involved in my care; that explicit follow up is communicated to me or my advocate so there is not chance for medication or medical error.
  • Transcript

    • 1. The Empowered Patient of the 21st Century How Technology Enables Good Medical Practice
    • 2. Presented by Nancy B. Finn,  Healthcare journalist and thought leader, author of e-Patients Live Longer, The Complete Guide to Managing Health Care Using Technology
    • 3. Key Points  Profile of the 21st century empowered patient (e-patient).  Priorities of an e-patient.  Digital Tools.  Why Communication and Collaboration are so important.  Challenges for providers and patients.  The Future.
    • 4. The 21st Century Patient Profile  Smart, well read  Used to constant communication from many media  Concerned about their health and their family’s health  Confused and overwhelmed with the complexity of health care today  High Expectations
    • 5. What Are the e- Patient’s Priorities?  Compassionate care  Complete Attention, open, two-way communication  Care that puts safety and security of the patient first  Full information at the point of care  Access to resources needed to understand medical issues • Clear discharge instructions including specifics about medications, follow up appointments, and home care.  Availability of a patient advocate if needed
    • 6. Compassionate, Safe Care Patients want care that is:  Thoughtful  High and personal Quality and Safe  Incorporates  Efficient joint decision-making and Economical  Patient-Centered
    • 7. Full Communication: Gimme Me My Data     Access to the data in the health record (Open Notes). What the patient will do with the data. Do patients really want the data? What sort of problems does this create for the provider?
    • 8. Challenges For Patients Understanding what is happening. Learning how to navigate the system. Cost and consequences of care. For Providers Dealing with stresses of care environment. Incenting patients to become engaged/empowered. Viewing patients as full partners in their care. Providing appropriate enabling tools.
    • 9. Savvy Providers Know that patients are seeking patientcentered, participatory health care Foster better communication and collaboration, using technology to enable this. (e.g. email, portals, e-visits) Are sensitive to the needs and desires of each individual patient Continue to adopt and implement new technologies
    • 10. Savvy Patients  Want communication and collaboration  Expect to be kept fully informed  Use digital communication tools to be in touch with their personal health and to interact with their providers  Expect to be treated as full partners in the healthcare decision process
    • 11. Tools for e-patients & savvy providers          Digital health records Email Patient Portals Health Information Exchange Smartphones/Chronic Care Monitoring Tools Online resources including the web and social networks Cloud computing enables the data repository Chronic care management tools Telemedicine
    • 12. How Patients Use Digital Tools? Go Online for heath information to diagnose health issues themselves or to be armed with information to discuss with providers Use smartphone apps to monitor conditions and measure diet, fitness, vitals Engage in conversations with others on social networks about their health issues Email their providers for faster response to get rid of telephone tag Use patient portals for secure communication, online conversation, to view labs and get referrals and prescription renewals
    • 13. Where do Patients Get Information  70% of U.S. adults get information, care, or support from a doctor or other health care professional.  60% of adults get information or support from friends and family.  24% of adults get information or support from others who have the same health condition.  The vast majority of this care and conversation takes place offline; small group of people communicate online. (PEW study: Health online 2013)
    • 14. Web Resources  Information overload  Google Search option  Best web sites for information include: Sites sponsored by well respected health institutions e.g. Mayo Clinic Sites sponsored by health societies e.g. cancer.org Other general sites e.g. medlineplus, Healthfinder.gov, webmd.
    • 15. Questions to Ask when Selecting Health Sites Health  Who developed this site?  Was it properly vetted by health care professionals? Has the site been updated recently? Is contact information provided? Can the information on the site be verified? Does the site have a seal of approval?    
    • 16. Social Networks  A social network is a community of individuals who engage and have similar interests.  Examples include: Facebook, Twitter, You Tube, Patients Like Me –Daily Strength, ACOR, ICYou, My Family Health
    • 17. Patient Centered Care, History and Definition “Respectful of and Responsive to individual patient preferences needs, and values and ensuring that patient values guide all clinical encounters.” (IOM Crossing the Quality Chasm, National Academy Press, 2001)
    • 18. Hallmarks of Patient- Centered Care  Team Approach  Patient Included in important health decisions when there are diverging opinions or multiple options:  Long-term relationship - Medical Home  Use of Digital Communication Technology
    • 19. In-Patient Care Choosing a Hospital – Hospital compare Quality check HealthGrades Access to EHR Communication and coordination among providers Follow up /Recovery services plan
    • 20. Patient Advocates The patient must have a voice on the care team. Advocates:  Family,  Friends,  Social workers Signed legal document appointing an advocate.
    • 21. Chronic Disease Management  More than 120 million people suffer from chronic conditions.  Patient participation in managing and monitoring these conditions is critical.  Five steps in patient self management: (Shared responsibility between the patient and the provider)  Collection of data.  Transmission of data.  Evaluation of information & agreement on treatment choice.  Notification among health team (patients and providers).  Executing the intervention/treatment.
    • 22. Chronic Disease Management Tools Home monitoring machines Smartphones – Newest technologies  Smartphones  Web resources  Home monitoring systems  Weight scales, glucometers, blood pressure kits and peak flow meters  Wearable devices to measure pulse and heart rate fluid retention
    • 23. Connected Health Bringing care to those are homebound.  Telemedicine – uses expanded bandwidth and technology such as video, robotics.  Addresses the shortage of physicians; Healthcare to underserved populations
    • 24. What the Future Holds Patient at Center Stage  Personalized Medicine/ Genetics and Genomics  Implanted Microchip & Continuous monitoring of chronic conditions  Robotic Surgery
    • 25. Contact Information Nancy B. Finn nfinn@comcast.net www.healthcarebasicsinfo.com 781-444-8421