Meeting Patient Information Demands In An On-Demand Society
by Dr. Steven J. Kraus, D.C., D.I.B.C.N., C.C.S.P., F.A.S.A.
Sports scores delivered to your mobile phone. News feeds direct to your inbox. Instant Twitter updates to your online followers. You may not be taking advantage of all of the personalization and immediacy that the information age affords, but many of your patients are. It’s a fast food world of information and immediate gratification, and consumers are saying, “Feed me now.”
PHR's being fed from your EHR
New meaningful use rules point to patients having access to clinical data such as test results, radiology findings, etc. – to their personal health records (PHR). But what are the requirements for your qualified electronic health record (EHR) to accomplish this? Your system has to have the ability to send information digitally – internally and externally. This facilitates instant, also potentially more secure and accurate, data sharing with other healthcare facilities and with patients themselves.
It's a fast food world of information and
immediate gratification, and consumers
are saying, "Feed me now."
In addition to office efficiencies, you can create closer relationships with your patients simply by way of “looping them in” to their own health information, as quickly as possible. Because, let’s be honest, what’s more frustrating and nerve-wracking than waiting for test results?
In the current paper world – which is still the M.O. for many doctors – it can take two to three days to send and receive information. For clinical test results of, such as an MRI, that are normal, you can give the patient peace of mind quicker when you inform them electronically. More and more, they will be looking for that report sent directly to them digitally. If the results are abnormal, you can add to the digital message, “You are scheduled for Thursday at 9am to review the actual MRI images. Dr. Modern will explain your options with you at that time. Please call if you need to reschedule.” Doctors on top of their communication game are favored by patients and perceived as efficient AND caring because you demonstrated the concern for immediate feedback and communication to help the patient understand. Of course, nothing is better than an immediate phone call to the patient from the actual doctor. In today’s world, getting hold of some patients is difficult during business hours. Automated communication electronically saves time and still gives the patient what they want; information now.
With either method of information delivery, you’ll still have to follow-up in many cases for abnormal results or next steps discussion in your evaluation and management of the case. When patients learn about their health status faster, they gain a sense of security rather than the fear of the unknown. Do they have a disc herniation? Do they have cancer? Fear of test results or X-ray findings can create anxiety in some patients or a restless night of sleep loss. Anyone who’s ever waited for results, knows that time is priceless. Therefore, you can significantly elevate your status with patients who feel you’re responding to them quickly and with due care.
PHR vs. EHR
Patients own their PHR's. As PHR's become the standard, patients will have all of their health data at their fingertips, literally. The time is not far away when everyone can carry their records around on their mobile devices; iPhones, cell phones, PDA's and mini laptops. This gives patients control of their own information. And that’sa good thing. This is different from the information in your EHR, which is still yours. Consider a PHR the patient's athome health file containing their records from all healthcare providers they have seen. Some patients may even maintain all their test results.
Further – based on current CMS objectives and national health information technology directions – insurance companies and Medicare will likely require that documentation for every patient encounter be attached to your bills possibly as soon as 2015. Sounds like a bit much? The healthcare world had better get used to it – EHR will be a central component of your practice, or you won’t be in mainstream practice at all. If EHR isn’t in your repertoire soon, you will simply be out of modern practice and isolated on a fringe island, practicing as though you are not interested in the patients’ total health nor interested in communicating with the patients’ other health care providers, for the betterment of the patients’ overall health management.
Some states have already passed legislation requiring you to have a CCHIT-certified system in your clinic by 2015 or you won’t be allowed to practice in good standing; just check out Minnesota for example.
You might ask, “If the federal government can’t see my records, how will they know if my system is compliant?” Big Brother can audit and look at your EHR records… just not over the internet; you’ll still have to submit data, for now. As mentioned, in the future, they will have your records because each encounter will have digitally attached documentation to the billing claim that was also submitted electronically. Requests for records will be a thing of the past in the next decade, third party payers will have it in advance of your getting paid.
Only you can decide if your patients’ records are sent out (after patient consent, of course). And, even then, it will go out encrypted. Just as with today’s compliance regulations, you should get prepared for being unable to bill third parties, unless you’re on the EHR path.
It’s an instant world and everyone wants instant results. And, let’s face it: This is as it should be. Patients should have access to their own healthcare information when they need it, without delay. Our role is to get it to them, to help them understand it, and to use it toward a positive outcome. This leads to increased patient satisfaction and affirmation that working with you was the right choice for doctor selection. Being a part of the healthcare system is the only way chiropractic will significantly increase our market share.
Dr. Steven J. Kraus is CEO of Future Health, Inc., a company that partners with chiropractors to deliver a comprehensive clinic management solution, including fully-integrated EHR. Dr. Kraus is a recognized expert in building successful clinics, having developed and sold 18 practices of his own and provided strategic consulting services to more than 400 healthcare businesses. He offers leadership to numerous industry associations and currently serves as the Chairman of the Iowa Board of Chiropractic. Contact Dr. Kraus at skraus@Future- HealthSoftware.com for more information.