Healthcare is struggling. Costs continue to rise and the quality of care is questionable in many cases. With the demands of the new healthcare market, we’ve adopted a “more is more” mentality for the industry. This is in direct contrast with the technology advancements of late. For the most part, the healthcare industry has not caught up with the age of instant gratification, of real-time connectivity, of sharing. Patients no longer want to be passive recipients of medications and treatments suggested by their doctors. Instead, they want to be involved in their healthcare decisions and have their doctors understand and address their actual needs—not just give them something to ameliorate the pain.
As consequence, face-to-face time between doctors and patients has become very comptetitive. With less personal interaction, the human element that used to be such a big part of medicine can often feel negligible. In a time when patients are looking for a closer relationship with their doctors, these practices end up pushing them away.
In the course of my lifetime I have been fortunate to not have any serious illnesses or injuries. My interactions with my primary care doctor's (PCP) office were usually minimal and annual. Learning about changes in healthcare and the emerging use of the electronic medical record systems (EMR) had to be done through research based on others' experiences. All that changed this past winter when I came down with pneumonia.
Suddenly my PCP visits became very frequent and were coupled along with radiologists, specialists, and emergency room visits... And I got to experience the dysfunction of the healthcare industry first hand. With each visit, I was verbally collecting a lot of complex information very quickly from multiple sources. It was becoming nearly impossible to keep everything straight or remember it later. Sure, I had some print outs to take home with me, but there would always be the lingering questions in my mind. “What did she say my white blood cell count was? It was high, but how high is high?” I was becoming more and more frustrated when I should have been focused on getting better.
Patients indicate high levels of dissatisfaction with the level of care they are receiving today. Based on my experience, I'd have to agree with them. As a way to combat this sense of helplessness, more and more people are adopting alternative treatment methods that put a larger emphasis on the human experience. One of the ways in which patients can be brought back to traditional medicine is through a shift to human-centered thinking by healthcare providers.
The turning point
A few days after failing to make sense of my lab results, my PCP set me up with access to my personal EMR. My doctor's office was in the process of transitioning over to a single, integrated health care system and now I had access.
My first feelings were elation and excitement. I signed in and clicked every link, I read every lab report, I left nothing undiscovered. I even read the reports from my annual check up visits for comparison. Finally, here was everything I wanted to see—from all the different offices I had visited—at my fingertips. If I didn’t remember the name of a medication, I could now look it up. I learned what a high white blood cell count actually was and what it should be.
By getting access to my history I learned about myself in ways I never knew. With this tool I became a more knowledgeable patient. The next time I went in to check on my recovery progress I had better questions to ask and could be more specific. The answers I received in return also became more specific and helpful.
My PCP’s decision to move into an integrated EMR system was a step in the right direction. It made dealing with and healing from pneumonia (a scary prospect for anyone) a lot less stressful, and it gave me the tools I felt I needed to understand what was happening to me. But there’s still a lot left to be done to fully deliver the experience patients deserve…
While the introduction of EMR vastly improved my experience, I was left with some questions and concerns that need to be worked through. The security of my information was the first one that came to mind and one that many patients with access to their EMRs are worried about. Other questions that wandered through my mind included...
“What if I have caretakers, would they be able to easily access my information?”
“What if there are notes that would lead to negative patient outcomes, in a psychiatric case for example, how would they be communicated to me in a thoughtful way?”
And the ultimate question as I obsessed over reports: “Is this EMR interaction taking the place of effective treatment?”
Since my initial interaction with the EMR, it has been updated to now include appointment requests, refills on prescriptions, bill payment, and even a way to send photos of visible symptoms to my PCP before an appointment. It is becoming a full service portal for all my medical needs.
Conevenience is a huge factor being addressed by these systems. So is transparency. However, current data systems are not human-centered for the most part. Our goal should be to create systems that are focused on the interaction and relationship between doctors and patients, as opposed to only serving numbers, facts, and figures. There is much more to a person's health than just the numbers provided from tests conducted, and the way technology is employed to communicate this data should relate to how patients and doctors interact. It must facilitate a human connection, it must be conversational, and it must embrace context.
Contextual data would mean that the facts and figures are still highly relevant for determining the course treatment, but that they would be used in the context of the relationship between doctor and patient, and the very human issues surrounding the patient's life. By understanding the patient as a complete human being, instead of only looking at test results, a doctor will be much better able to prescribe treatments that may actually work to help the patient feel better and a patient will feel a lot more confident about the care she is receiving.
This human-centered approach is vital to making sure both doctors and patients can embrace technology and move forward with confidence in the healthcare system.