Of all the talks, pitches, and bar-side debates during HIMSS15, three statements in particular keep cycling through my head. To paraphrase:
“Patients need to be first order participants in their care.”– Doug Fridsma, MD, president and CEO of AMIA
“We need to do a better job of getting information into the hands of patients and family members in real time and not after the fact.” – David Muntz, CIO/SVP of GetWellNetwork.
“The exciting part of healthcare is happening now.” – Omar Hussain, president/CEO of Imprivata
The healthcare IT agenda appears to be shifting and the patient is at last becoming the true focus of our efforts. In recent years several patient advocates such as Regina Holliday and e-Patient Dave have pushed for patients’ rights and urged stakeholders to enable patients to be active participants in their own care. Finally the rallying cry seems to be going mainstream.
But why now? A few theories:
The Beyond Meaningful Use Era. For the last five to 10 years, healthcare IT has been focused on EHRs. Providers have been busy chasing Meaningful Use dollars and have been consumed with the selection, implementation, and meaningful use of core EHR technologies. We’ve now moved beyond the initial Meaningful Use frenzy as the majority of providers have an EHR in place or are well on their way towards full implementation. Financial and human resources are becoming more available, allowing organizations to consider other projects, such as ways to maximize the use of their EHRs and address gaps in usability and workflow. Interoperability and engaging patients have become priorities.

Stage 2 and 3 Objectives. Even though Meaningful Use may no longer be the hot topic, it remains a priority. Stages 2 and 3 include requirements for engaging patients and exchanging clinical data. Interestingly, CMS released a proposed rule the Friday before HIMSS that included a water-downed version of the Stage 2 patient engagement requirements. The proposed rule reduced the requirement that five percent of patients access their health data electronically to the much lower requirement of a single (one) patient. This change created a bit of an uproar among patient advocates, as well as former ONC leader Farzad Mostashari, who called for a “National Day of Action” involving consumers who would collectively demand access to their medical records. As the HIMSS conference kicked off, there seemed to be a heightened awareness – or at least louder vocalization – that we must do better when it comes to involving patients in the care process by engaging them inside and outside of healthcare facilities and making their clinical records readily available.
Maturing technology. I heard more than one thought leader at HIMSS comment that the industry’s interoperability/workflow/engagement/fill-in-the-blank problems are not the result of inadequate technology. After all, we can access our money from any ATM in the world; we can buy just about anything we want on the Internet with just a few clicks; we can instantly communicate with friends and family anywhere in the world as long as we have a smartphone. If there are technology gaps, we know there are hundreds of Silicon Valley start-ups ready and willing to churn out a solution.
In other words, patients know that it’s technically possible for physicians to give them rapid access to an electronic version of their records. They know they should be able to make an appointment request at 1:00 in the morning and have a response within 24 hours. They know it’s ridiculous to fill out forms with the same information every time they see a new doctor. We can no longer hide behind the argument that the technology does not exist.
The sophisticated patient and caregiver. Once upon a time, patients rarely questioned advice from their doctors. Today that’s not the case. With Dr. Google at their fingertips, patients or their caregivers are becoming increasingly involved in their own care. Most want to be first-order participants in their health and desire immediate feedback from their physicians. When referred to a new provider, they want the new doctor to have their records in hand prior to the visit. Thanks to changes in the consumer world, patient expectations for service have evolved and it’s now time for healthcare to play catch-up.
All this brings me to the third quote that “the exciting part of healthcare is happening now.” This year at HIMSS the buzz was not just about the geekiest new technology, the biggest sale, or the latest vendor acquisition.
Now the buzz centers around the patient. And that’s exciting.
Michelle Ronan Noteboom
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