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I would like Patient Portals to give access to more information from the chart. We use eClinicalWorks. I think it would be ideal for patients to have access to more of their medical record as their PCP has organized it. This is more uniform than PHRs organized by the patient, and avoids duplication. Patients should be able to upload docs but allow their PCP to put it in the right spot on the chart. Some records should not be available to the patient, arguably, like a biopsy report that has not been discussed yet.
I also think patients would not worry about statewide or national HIE if they could see what gets posted to it.
As a PCP, widespread single login HIE would greatly help us keep our patients stay safe and our care manager find out where they are in the healthcare system.
We are an NCQA Level 3 PCMH. We are part of a pilot that requires reporting on 18 adult CQMs. MU and PQRS also require CQM reporting. CQMs need to be unified and automated by EHR companies. Our EHR company is now trying to charge for data extraction on CQMs that should be automated. This poses added obstacles to the movement from data extraction to analysis to practice change.
We also find that some CQMs are CPT-based and can’t be generated by PCP offices. The insurance cos should use claims data to generate them and report back to PCPs. Example: mammogram and colonoscopy. We can use our registries to identify the actual patients in need of testing.
Finally, a KLAS rep informed me that EHR companies foresee statewide HIEs becoming obsolete. That would be the opposite of… more »
Thanks!!! « less
I love sharing information with my patients. Since starting with EMR in 2006, I give every patient a copy of his/her note at the end of every visit. Most patients love it, and the ER doctors and specialists love it as well. I was called a revolutionary by a respected colleague two years ago but am glad to see research published on the benefits of information sharing with our patients. It is key to patient engagement for them to own not only their information but their health. Patients should be empowered. In the end, though, they still need the guidance of excellent PCPs who stand at the ready to guide them.
1. Existing Patient Portals: Let’s give patients access to their information. First, we need challenge doctors and other healthcare providers to accept the wisdom of information-sharing with patients (perhaps giving mental health an exception, due to sensitive information). Then, challenge the vendors to expand patients’ access to their charts through existing secure Patient Portals (eCW has an excellent one). Also challenge them to provide a mechanism where a patient can upload information to their chart which, upon review and categorizing by PCP or primary care office, would find a place on the shared electronic medical record.
2. HIE access for patients: I favor single secure login wherever possible. I believe patient portals have to have banking-level security already,… more »
The government should support patient-empowerment movements like PCMH. « less
I think the government could challenge to providers, hospital centers, etc to see the wisdom of transparency and information sharing with patients. Research shows that patients experience higher quality care when they have access to their information. I also believe it contributes to patient safety and lowers cost by avoiding redundant tests (for example, the patient knows when the last colonoscopy was). Models like the PCMH will likely push for more information sharing with patients through Patient Portals. It would be good for the government to set standards for Patient Portals so that the vendors develop features that improve patient care.
The more useful information and the more features (like secure messaging and self-scheduling appts) will improve patient adoption of Patient… more »
As far as HIE, I am not sure how you could design it so that a patient could access/view what information is shared on a platform; however, I believe this might settle the anxiety of people who are concerned about privacy.
In Maryland, we have also talked about whether MOLST/POLST forms could be posted through HIE so that end-of-life orders are available across the care transitions. I think it would be a nice addition to also allow patients, perhaps via their PCP, to post Advance Directives to the HIE. « less
We are implementing the encounter notification service (ENS), which is still being tested by CRISP. Our hope is that our workflow can encompass the following strategy: use ENS to locate our patient in the healthcare system, go to the Provider Portal to access information, communicate provider-to-provider, obtain test results and discharge summaries prior to patient visit here, and see our patients within a week of discharge from the ER or a hospital.
We are hopeful that CRISP will evolve a single login, embedded within our EMR, that will allow us to access all of the useful features of the HIE they envision: ENS, Provider Portal, secure platform for in-writing provider-to-provider communication, and MOLST/POLST form access/update.
An added icing on the cake, which we believe is crucial,… more »
I agree with a recent comment that we are working with real patient, not an iPatient. Nothing will replace the in-person encounter. « less