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Automation is good. Robocalls are bad.

I just got a robocall from my primary care physician’s office asking first if this was actually me — not that anyone would actually lie — and then if I had received a flu vaccine this season. Well, the practice itself administered the vaccine last month, so they should have known that the answer was yes. I did say yes to the interactive voice-response system and also provided the month, as asked.

I realize it is good to make sure that patients get the  recommended preventive care and that it may be impossible for staff in a small practice to call every last patient, but robocalls are awfully impersonal. If the system had actually been connected to the practice’s EHR, I wouldn’t have needed to get the call in the first place. Or maybe someone forgot to enter the vaccination into the record? In either case, the process is imperfect.

Yes, it’s a small deal, but how many imperfect processes are there in medicine? Little things have a way of adding up.

December 11, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My first portal experience

Yes, after all these years of writing about EMRs, EHRs, PHRs, patient portals and the like, I have had my first real personal experience with a patient portal, courtesy of my internist.

He still has a small practice, with four other physicians, including one fresh out of residency. Those small practices are a dying breed, but this doctor is changing with the times, too. He recently offered a concierge option for a few hundred patients. I declined because I don’t need to reach him that urgently.

The portal has been in place for a couple of years, and I may have logged in once or twice before to set up an account, but didn’t really do anything other than look around. This time, prompted by an e-mail informing me of a new URL, I logged in and checked my medication list. I remembered that another doctor had changed the dosage of one of my medications a while back, so I fired off a secure message informing this practice of the change. (It was a new URL presumably because the EHR vendor formerly known as Sage Healthcare adopted the Vitera Healthcare Solutions name a year ago and was switching its customers to a common, white-labeled portal.)

I also looked at some of my test results from a year and a half ago just to confirm that everything was more or less OK then, though I did see one abnormality with my HDL cholesterol. I last went for a physical in March 2011, about a month after I ungracefully cut my face open on a bathtub in Orlando during HIMSS11, so I was probably due. This practice lets patients request appointments — not actually choose open slots — online, so I sent my request. Tonight, about 24 hours later, I got my confirmation, and I’ll be seeing the doc in a couple of weeks.

It’s not a perfect system, but it was convenient enough for a night owl like myself who might not remember to call during business hours to make an appointment or simply not want to wait on hold or press a bunch of buttons to navigate a telephone menu. I did not see the Blue Button option to download my record that the federal government is pushing private vendors to adopt, but I’m sure that will be there by the time the practice is ready for “meaningful use” Stage 2 in a year or two. I don’t have a PHR anyway, so I wouldn’t be able to do anything with the data other than print it.

I suppose I should set up an emergency PHR at some point, even though I doubt any hospital or specialist I might get referred to would take the time to download my data from a USB drive or log into someone else’s portal. Untethered PHRs simply don’t fit physician workflow. That might change in MU Stage 2 when providers will have to send electronic discharge statements and patient summaries during transitions of care, but I’m still not convinced a patient-controlled PHR will be the right vehicle for these data transfers.

 

October 31, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: This time, I’m the interviewee

In a rare turn of events, I’m the one being asked the questions on a podcast by Sivad Business Solutions, which hosts regular audio discussions on a variety of business topics. I give kind of a high-level view of health IT and offer my very strong opinions on patient safety and healthcare reform. There’s an interesting discussion about EHRs being designed to maximize reimbursements rather than assure safety.

Interestingly, we recorded this via Skype. I like the audio quality, if not the nasal quality of my own voice, more than usual that day.

Hopefully the embedded audio works. If not, click here.

September 18, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Why healthcare is so troubled, and what consumers are doing about it

Consumerism hasn’t completely caught on in healthcare, but it has gained a bit of a toehold. Consider these two slides shown Monday at the Healthcare Unbound conference in San Diego:

Look at the bottom of each slide, starting with the second one. According to GreatCall, maker of the Jitterbug phone for seniors, 35 percent of consumers plan to buy “wellness electronics” in the next year. That’s great news and a great opportunity for people in health IT to make sure such devices connect to larger networks to data collected will be usable.

In the upper slide, Kaiser Permanente cites numbers showing one reason why healthcare is in such a crisis. Again, look at the bottom. Just 2 percent of current residents in internal medicine will end up in primary care. That’s not exactly reassuring in the face of a projected shortage of 40,000 family practice physicians by 2020. Thus, connected devices will gain in importance as an adjunct to primary care for the purpose of disease management.

Really, it could be our only hope.

July 12, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.