The original motivator for electronic health records and exchanging health information (way back in the dark days of the late 20th century) was to make it easier, safer and cheaper to take care of patients. The push came largely from managers looking to reduce the transaction costs of care and providers trying to reduce the administrative overhead of care so they could spend more time dealing with patients.
However, the more I deal with health information systems, the more I see that the best and highest purpose is not for management or even professional use. Rather, it is for patients. Giving patients their own information, (in the right format, via the right medium, at the right time, and from the right source), does more than enable them to make better decisions, it engages them in their care. It motivates them, educates them, energizes them, and empowers them. Whether any specific bit of information is, by itself, critical to the patient's care is not the whole story. The mere act of sharing the information with the patient turns the patient from a passive passenger on the health care bus to the driver, choosing the destination and calling the stops.
What happens when you engage patients with chronic care by sharing their personal health information with them?
1) They like it. Really, really a lot. HIE with patients is a big satisfier.
2) It generates scheduled care, notably primary care.
3) It reduces the need for urgent and emergency care and hospitalizations.
4) It saves a huge amount of money.
(Oddly, it seems to do all this without improving the patient's disease control, their physiologic state. The mechanism for this is unclear, but more on that later.)
It's early days yet and exactly how best to share information, which information, and so forth is by no means completely clear. However, there are some very well documented examples that work and are ready for deployment now.
If you would like to learn more about this, you might want to check out a recorded webinar featuring yours truly:
I'll also be doing a presentation at the Spring Managed Care Forum in Orlando on April 15.
