O-Patients
When Consumer Driven Health Plans (CDHP) made their debut, they promised to empower me equally a consumer too let me to brand my ain decisions on how to pass my wellness aid dollars. I thought this was wonderful, until I realized that equally an empowered wellness aid consumer, I instantly cause got to pass coin I didn’t cause got to pass earlier too I cause got to brand decisions close forgoing treatments based on their costs. Empowerment normally translates into additional expenditure of both coin too fourth dimension too a requirement to brand difficult choices where none were needed before. I would cause got chosen to decline this empowerment offer, but unfortunately, since my employer was the determination maker, I was non empowered plenty too my empowerment became mandatory.
I am instantly observing the e-Patient too Participatory Medicine movements. These also want to empower me to participate inward my ain wellness care. I am supposed to kicking the bucket “equipped, enabled, empowered too engaged” inward my ain wellness care. After spending close 20 years inward diverse academic institutions, I shout out upwards I am pretty good “equipped”. I don’t know what “enabled” agency inward this context too my CDHP sense makes me really suspicious of "empowered". Just similar most people, except of course, the poor, uneducated too elderly, I did search for wellness information online, too I would similar access to my family’s medical records, primarily so I tin strength out impress out a schoolhouse immunizations listing without having to pay $10 per page. As to “engaged”, twenty-four threescore minutes menses of the month is gradually beingness defined past times the Government, the e-Patients antechamber too diverse other interests, equally active involvement inward maintaining your Electronic Health Records (EHR), including total ownership too interpretation of “raw data” exterior a provider organization. I may live on equipped, but I am non willing to dabble at the exercise of medicine too I pass upwards to kicking the bucket “engaged” inward this manner. I cause got no want to pass countless hours aggregating information from diverse providers, analyzing it (or having it analyzed), proof reading everything too becoming my ain Medical Home. But so again, I am non large on “do-it-yourself”. I’d rather exit accounting to accountants, plumbing to plumbers too medicine to physicians. I suppose this makes me an o-Patient, along amongst the vast bulk who is neither equipped, nor enabled too non fifty-fifty remotely inclined to actively grapple their medical records at all times.
If you lot read this, you lot should also live on aware that the Government is proposing to pay providers for adoption of EHR software too Meaningful Use of it. Influenza A virus subtype H5N1 important percentage of that Meaningful Use is making medical records available to patients for viewing too fifty-fifty downloading through Blue Buttons. This is a goodness affair too technically rather inexpensive too slow to accomplish. Josh Seidman PhD has a beautiful too touching story on how availability of medical records online allowed him to participate inward his father’s aid from afar. But this unproblematic too powerful achievement doesn’t look to live on enough. e-Patients too their innovative startup supporters want much to a greater extent than included inward Meaningful Use, too Meaningful Use is rapidly becoming the designing for our wellness aid delivery system. Meaningful Use includes no provisions, or requirements, for primary aid physicians to aggregate too grapple medical records for their patient panels, but it does include an e'er increasing array of functionality that enables patients to do the same. Providers are non paid to aggregate medical records too patients are touted equally the ultimate complimentary resource. Empowerment is looming large.
On Apr 20, 2010, the Office of the National Coordinator on Health Information Technology (ONC), who is defining Meaningful Use of EHRs too thence also redefining how medicine is practiced inward the U.S., held a populace hearing on Patient/Consumer Engagement. The presenters were the common learned luminaries that you lot would expect; EHR vendors, silicon bit manufacturers, academic institutions, other question fellows, wellness aid corporations, a pair of community services representatives, innovative startup companies too of course of education a famous e-Patient. There were no o-Patients inward the room. ONC heard precisely what they wanted to hear. It is imperative to let patients access to their medical records. But they also heard, from the e-Patients representative, that patients quest EHRs to cause got “open APIs” so information tin strength out live on extracted inward whatever format they wish. I couldn’t aid but wonder how many patients or consumers are familiar amongst the term “open API” too how would an “open API” serve individual similar Josh Seidman who only wanted to read the medical records.
On June 5, 2010, the ONC had some other public hearing. This i was close using Health Information Technology to eliminate disparities. I was really hopeful that this hearing would live on close o-Patients, too it was. The participants were highly educated, really good important folks who dedicated their careers to helping the segment of o-Patients who is really sick equipped to bring together the information age. Along amongst reiteration of the dubious calls for extracting information from providers’ EHRs, ONC heard some serious concerns regarding lineament too availability of HIT inward little practices which serve most Medicaid o-Patients, too mayhap these discussions were component division of the argue for Dr. Blumenthal’s recent appeal to HIT vendors to include providers serving minorities inward sales too marketing efforts. Just similar the previous hearing, this populace coming together included no o-Patients too no practicing physicians.
So hither is a proposition for ONC’s adjacent populace hearing. If you lot actually want to sympathize what people quest too want, why non inquire them? When you lot exit dwelling inward the morning time cause got a bunch of populace hearing invitations amongst you. When you lot halt to fill upwards gas, hand an invitation to the attendant. As you lot pay for the latte at your favorite java shop, mitt an invitation to the barista. When you lot cross the green too give away the ii older gentlemen warming upwards on a bench, mitt each i an invitation. Hand i to your administrative assistant too. When you lot kicking the bucket out for lunch, invite your waiter or the fiddling Italian Restaurant possessor himself. If you lot cause got a taxi there, invite the driver. Assuming you lot piece of job long hours, you lot should live on able to run into the cleaning crew. Give each i an invitation. If you lot acquire a speeding ticket driving home, invite the officer. Finally, when you lot halt at the grocery store for milk, distribute the remaining invitations to the immature checkers too the elderly baggers.
My estimate would live on that none of these folks volition demand “open APIs” or “data extractions” too most importantly, none of these o-Patients volition want to live on forcibly empowered to cause got over the active management of their medical records. As long equally e-Patientship is optional for those interested, it is a really positive too inspiring phenomenon. We do quest to proceed inward take away heed though, that all those “open APIs”, “data extractions” too “untethered PHRs” terms coin too eat physicians’ time. Since I am non aware of whatever offers from e-Patients and/or data-seeking startups to pay for actual information collection too extraction, mayhap it would live on wiser at this betoken to pass our scarce resources on wellness services amongst broader appeal too ameliorate utility. The twenty-four threescore minutes menses the medical profession relinquishes, or is forced to relinquish, its final shreds of responsibleness for whatever semblance of aid coordination too continuity of care, too farms it all out to freshly "empowered" unsuspecting patients too their “untethered PHRs”, volition live on a lamentable twenty-four threescore minutes menses indeed.
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