Keith Loria is a contributing writer to Medical Economics.
Patients are torn between whether they want their physicians to use technology or not.
A recent study by Black Book Research revealed that tech-savvy patients expect their doctors to use health information technology, however, another study by the same research company found that patients don’t trust health IT. This presents quite a quandary for physicians who want to appease their patients’ desires but don’t want to scare them away.
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The research also showed that 94% of physicians said they’re deluged with what they think is useless data.
Kevin Grassi, MD, a pediatrician at Glens Falls Hospital in New York, and chief medical officer and co-founder of PatientBank-a company that helps patients gather, store and share their medical records-notes maintaining the electronic medical record is absolutely overwhelming for doctors, and understands why many are frustrated.
“I believe that much of that comes from the fact that we do little with the data we gather in healthcare,” he tells Medical Economics. “Of course there are institutions that use healthcare data in ways that improve their patient’s health, but the lack of interoperability [different EMRs don’t communicate) limits the interesting things you can do with the data.”
Rachel Carlton Abrams, MD, a board-certified physician in family and integrative medicine, appreciates when her patients track their health data, as it allows her to be far more accurate in her assessment and recommendations.
“It would be naive to imagine that our patients won’t be trying the latest gadgets for personal health monitoring (and wanting to share the data with us), or using the power of the internet to research their own conditions,” she told Medical Economics in an email. “I like to see this as a positive step. I appreciate a patient actively engaged in his or her own wellness. This makes the likelihood of finding effective interventions for their condition much higher.”
Kristen Heffernan, general manager, Henry Schein Medical Systems Inc., developers of MicroMD Practice Management and Electronic Health Records, notes millennial expectations for on-demand care, price transparency, quality and value are helping to drive the use of health IT, and Baby Boomers have also become more savvy in their use of technology.
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“Realistically, all patients desire easy and efficient ways to navigate the health care system and connect with their providers,” she says. “While not every patient may be as tech savvy or agreeable to using the offered HIT tools, the tools offer a level of choice, access, autonomy and efficiency that patients desire.”
Given the skill level of hackers in a 2017 world, Abrams isn’t sure she can reassure her patients that health IT is 100% safe.
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A study by the Ponemon Institute in 2016 (sponsored by IBM), revealed that there were record numbers of patient records compromised over the last two years, citing hackers’ desire to go after networks, systems and applications that have been misconfigured or are not maintained properly.
Heffernan says that a completed HIPAA security assessment, addressing security gaps and making an ongoing commitment to enhancements, monitoring policies, technology and processes, is critical for practitioners to ensure the security of electronic protected health information (ePHI).
“With those elements in place, practices can communicate their commitment to securing sensitive patient information to their patients,” she says. “At Henry Schein, we encourage our customers to organize a team to create a communication plan with the goal of educating patients on security methods and policies, including the security of third-party tools before having to ask patients to use health IT.”
Providing patients with resources on how to secure their own devices, passwords and ePHI in their possession can also help reassure patients of the security of their protected information.
If you have a patient who is concerned about the security of maintaining electronic versions of their data, Grassi says it’s very difficult to change their mind.
“The solution for this is ubiquity of the practice,” he says. “When more and more medical data is stored online in the cloud and used by patients, it will be seen as just ‘common practice.’ Before online banking existed, most people were wary about having their banking data online. Over time, people became less fearful and now view the practice as secure and the standard.”
Health IT is a catch-22. In the Black Box survey, 91% of tech-savvy patients want doctors to utilize more IT, yet more than half are skeptical about the benefits of healthcare information technologies and 70% feel it’s untrustworthy.
“I feel like we are training doctors to be sensitive observers of patient behavior and then blinding them by not letting them look their patients in the eye for most of the visit,” Abrams says. “The issue my patients object to the most is that their physician stares at the computer and types while in visits with them. They feel that their doctor is not listening. And to be honest, he or she is not observing the patient in the way that is necessary to do good, observational, connected clinical medicine.”
She believes that both patients and doctors would be better served by having scribes in the room to type, or developing systems that allow doctors to face the patient and still jot notes-on a tablet, for example.
“Both patients and doctors would benefit from spending a bit more time in their primary care visits,” Abrams says.