The federal government’s healthcare reform efforts have an ongoing theme of patient engagement. More and more patients are on board with data exchange, but clinicians must change long-held practices. Also, both clinicians and patients must embrace health IT to get to true patient engagement and the healthcare benefits that can be achieved.
“The government is hand and hand with the healthcare community in engaging the patient,” says Mary Griskewicz, senior director of health information systems for the Healthcare Information and Management Systems Society (HIMSS). Engaging the patient is a “value proposition for everybody.”
She cites the government’s e-Health Initiative in which organizations were asked to pledge how they would help data holders allowing users of this information become more informed and educated on the value of using health IT. There are now 400 pledges on record. HIMSS has pledged to align with the government by educating its members. HIMSS also recently created a new task force on personal health IT, she says.
One of the biggest challenges, Griskewicz says, is conveying the potential benefits of health IT to providers. Because primary care providers see a patient every 15 minutes, they need to use technology to their benefit. “We have to prove to them how these tools can improve patient care, decrease workflow challenges and reduce costs.
“The revolution that is health IT is contingent on patient demand, as well as provider acceptance and use,” Griskewicz says. “The technology is there. Now it’s a matter of consumers and providers continuing to learn to use the technology and adapt to it.”
CMIO spoke with two others leading patient engagement efforts.
RSNA Image Share
Patients can control the sharing of their medical images and reports with their physicians and medical providers through the RSNA Image Share network. Some data suggest that as much as 20 percent of imaging studies in the U.S., are inappropriate and that unavailable images and/or reports are one of the primary causes of unnecessary repeat imaging, says David S. Mendelson, MD, chief of clinical informatics at The Mount Sinai Medical Center in New York City and member of the RSNA Radiology Informatics Committee.
The project was launched in 2009 through a $4.7 million contract with the National Institute of Biomedical Imaging and Bioengineering to build a secure, patient-centric medical image sharing network based on a common standards-based architecture that would enable patients to control access to their information through personal health records (PHRs) without relying on CDs.
Participating sites educate patients on establishing PHR accounts with selected providers enabling them to retrieve, view, archive and share images and reports, creating a detailed longitudinal medical history accessible through any secure internet connection.
“Imaging is absolutely a good gateway for patient engagement,” says Mendelson, who is principal investigator for the Image Share network. Broader efforts for PHRs have failed, he says, because they tried to bite off more than they could chew. The advantage with this network is that it involves a targeted patient group with a specific need. “If these patients have relationships with early image-enabled PHR companies, it may serve as a gateway to adding another piece of information. This is a bottom-up approach instead of top-down.”
Mendelson is working on a survey for patients who have signed up for the Image Share network, hoping to find out how they like the service, how their physicians responded to it and whether the network drives down utilization. It will take more than the 500 enrolled patients to get a handle on the answers to those questions. For now, Mendelson considers satisfaction measurements the “low-hanging fruit.”
The anecdotal response to date has been very positive, he says. He has heard patients say ‘it’s about time’ for such access. Those experiencing technical problems are referred to Mendelson and even those patients want this to work and are willing to spend the time with him to work through problems. “But we need to acknowledge that this is a self-selected group of patients who wanted it when they heard about it.”
The network effort has uncovered other opportunities, Mendelson says. For example, pediatrics provides a good playing field for this type of network because patients and their families often go back and forth between big academic, tertiary medical centers