The document discusses how 21st century patients, or "e-patients", are empowered through technology to take a more active role in their healthcare by communicating with providers, accessing health records and information online, and using digital tools to monitor conditions. It outlines the priorities and expectations of e-patients, challenges faced by both patients and providers, and how savvy use of technology can enable patient-centered care and chronic disease management. The future will see even more personalized medicine and continuous remote monitoring through implanted devices.
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.
15. 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.
16. 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?
17. 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
18. 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)
19. 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
20. In-Patient Care
Choosing a Hospital –
Hospital compare
Quality check
HealthGrades
Access to EHR
Communication and coordination among providers
Follow up /Recovery services plan
21. Patient Advocates
The patient must have a voice on the care
team.
Advocates:
Family,
Friends,
Social
workers
Signed legal document appointing an
advocate.
22. 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.
23. 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
24. 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
25. What the Future Holds
Patient at Center Stage
Personalized Medicine/ Genetics and Genomics
Implanted Microchip & Continuous monitoring of
chronic conditions
Robotic Surgery
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.