Friday, November 21, 2008
When patients control their own records
Steve Spadt, ACP's Director of Interactive Product Development for projects such as the College's Diabetes Portal and the MKSAP product line, delivers a round-up of the latest in electronic health records, including patients taking control of their own health records and Web communities that let patients connect with other patients with similar symptoms and diseases, and possibly by-pass medical providers.
Learn more about the latest in medical informatics from the American Medical Informatics Association's annual meeting in Washington, DC.
Patient Health Records (PHRs) continue to gain steam, though there is a key differentiator which is whether or not the system is "tethered," meaning connected to or integrated with a full Electronic Health Record (EHR) or other clinician-managed systems. Medical informatics experts almost universally share the belief that untethered PHRs (systems that operate independently and contain data that is managed solely by patients) may actually negatively impact care as they could strain patient/clinician relationships as clinicians struggle to coordinate the data in their own systems with that in the patient's PHR--an effort that would further burden an already critically low level of time and resources available per patient encounter. AMIA'S journal recently addressed this topic.
The Patient-Centered Medical Home (PCMH) model is universally appealing, particular to primary care physicians who see the tremendous mismatch between the potential for the model to dramatically improve the quality of care and the current payment systems that conflict with the model. From the informatics perspective, successful implementation will depend largely on information systems and technology infrastructure that can facilitate and track teams as they deliver patient-centered, well-coordinated, high-quality care.
Clinical Decision Support (CDS) may finally be coming of age. Numerous resources are now available to assist physicians implement sophisticated decision support systems, including a guidebook whose lead author, Jerry Osheroff, FACP, is a leading authority in CDS and a former ACP staff member. A summary of key CDS initiatives and resources is available on AMIA's Web site.
Electronic Health Records (EHR) Adoption continues to lag behind predictions, limiting the impact of many informatics innovations. The long-expected "tipping point" of adoption appears to be gradually approaching, but it is clearly still not yet upon us.
Patient Communities are growing stronger and are increasingly empowered through the use of so-called Web 2.0 technologies that enable patients to connect with other patients with similar symptoms and diseases, share encouragement and treatment strategies, and even, in many cases, their own clinical data—a serious concern among informatics professionals already wary of the spread of PHR systems and other tools that may not be as secure or private as patients believe. One such community that is rising quickly in popularity is Patients Like Me, which was profiled recently in ACP Internist.
A Medical Informatics Update, presented by Daniel Masys, MD in the style of ACP's own Update series at the annual Internal Medicine meetings, focused on four broad areas in clinical informatics:
1) computerized clinical decision support,
2) personal health records,
3) telemedicine, and
4) the practice of informatics;
and also three areas in bioinformatics:
1) human health and disease,
2) model systems for understanding biology, and
3) the practice of bioinformatics.
He finished with a Late Night ... -style Top 10 list of Notable Events. All of the information is available online.
Labels: electronic medical records, health information technology
posted by Ryan DuBosar at
9:00 AM
Contact ACP Internist
Send comments to ACP Internist staff at acpinternist@acponline.org.
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Blog log
Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:
Albert
Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the
University of California, Los Angeles School of Medicine, where he
also did his internal medicine training. Certified by the American
Board of Internal Medicine, Dr. Fuchs spent three years as a
full-time faculty member at UCLA School of Medicine before opening
his private practice in Beverly Hills in 2000.
Zackary
Berger
Zackary Berger, MD, ACP Member, is a primary care
doctor and general internist in the Division of General Internal
Medicine at Johns Hopkins. His research interests include
doctor-patient communication, bioethics, and systematic reviews.
CasesBlog
Ves
Dimov, MD, ACP Member, is an allergist/immunologist and Assistant
Professor of Medicine and Pediatrics at the University of Chicago,
where he evaluates and treats both pediatric and adult patients.
David
Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally
renowned authority on nutrition, weight management, and the
prevention of chronic disease, and an internationally recognized
leader in integrative medicine and patient-centered care.
db's
Medical Rants
Robert M. Centor, MD, FACP,
contributes short essays contemplating medicine and the health care
system.
DrDialogue
Juliet
K. Mavromatis, MD, FACP, provides a conversation about health topics
for patients and health professionals.
Dr.
Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal
medicine for more than a decade and is an Associate Professor of
Medicine at an academic medical center on the East Coast. His time is
split between teaching medical students and residents, and caring for
patients.
Everything
Health
Toni Brayer, MD, FACP, blogs about the rapid
changes in science, medicine, health and healing in the 21st century.
FutureDocs
Vineet
Arora, MD, FACP, is Associate Program Director for the Internal
Medicine Residency and Assistant Dean of Scholarship & Discovery
at the Pritzker School of Medicine for the University of Chicago. Her
education and research focus is on resident duty hours, patient
handoffs, medical professionalism, and quality of hospital care. She
is also an academic hospitalist.
Glass
Hospital
John H. Schumann, MD, FACP, provides
transparency on the workings of medical practice and the complexities
of hospital care, illuminates the emotional and cognitive aspects of
caregiving and decision-making from the perspective of an active
primary care physician, and offers behind-the-scenes portraits of
hospital sanctums and the people who inhabit them.
Gut
Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist
at the University of North Carolina School of Medicine, and the
Program Director for the GI & Hepatology Fellowship Program. He
specializes in diseases of the esophagus, with a strong interest in
the diagnosis and treatment of patients who have difficult-to-manage
esophageal problems such as refractory GERD, heartburn, and chest
pain.
I'm
dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic
hospitalist with an interest in basic and clinical science and
education, with interests in noninvasive monitoring and diagnostic
testing using novel bedside imaging modalities, diagnostic reasoning,
medical informatics, new medical education modalities, pre-code/code
management, palliative care, patient-physician communication, quality
improvement, and quantitative biomedical imaging.
Informatics
Professor
William Hersh, MD, FACP, Professor and Chair,
Department of Medical Informatics & Clinical Epidemiology, Oregon
Health & Science University, posts his thoughts on various topics
related to biomedical and health informatics.
Just
Oncology
Richard Just, MD, ACP Member, has 36 years in
clinical practice of hematology and medical oncology. His blog is a
joint publication with Gregg Masters, MPH.
KevinMD
Kevin
Pho, MD, ACP Member, offers one of the Web's definitive sites for
influential health commentary.
MD
Whistleblower
Michael Kirsch, MD, FACP, addresses
the joys and challenges of medical practice, including controversies
in the doctor-patient relationship, medical ethics and measuring
medical quality. When he's not writing, he's performing
colonoscopies.
Medical
Lessons
Elaine Schattner, MD, ACP Member, shares
her ideas on education, ethics in medicine, health care news and
culture. Her views on medicine are informed by her past experiences
in caring for patients, as a researcher in cancer immunology, and as
a patient who's had breast cancer.
More
Musings
Rob Lamberts, MD, ACP Member, a med-peds and general
practice internist, returns with "volume 2" of his personal
musings about medicine, life, armadillos and Sasquatch at More
Musings (of a Distractible Kind).
Musing
of an Internist
Justin Penn, MD, ACP Associate Member,
attended medical school at the University of Washington School of
Medicine and trained in internal medicine at the University of
Rochester, where he is serving as Chief Resident.
Prescriptions
David
M. Sack, MD, FACP, practices general gastroenterology at a small
community hospital in Connecticut. His blog is a series of musings on
medicine, medical care, the health care system and medical ethics, in
no particular order.
Reflections
of a Grady Doctor
Kimberly Manning, MD, FACP,
reflects on the personal side of being a doctor in a community
hospital in Atlanta.
Technology
in (Medical) Education
Neil Mehta, MBBS, MS, FACP,
is interested in use of technology in education, social media and
networking, practice management and evidence-based medicine tools,
personal information and knowledge management.
White
Coat Underground
Peter A. Lipson, MD, ACP Member, is a
practicing internist and teaching physician in Southeast Michigan.
The blog, which has been around in various forms since 2007, offers
musings on the intersection of science, medicine, and culture.
Other blogs of note:
American
Journal of Medicine
Also known as the Green
Journal, the American Journal of Medicine publishes original clinical
articles of interest to physicians in internal medicine and its
subspecialities, both in academia and community-based practice.
Clinical
Correlations
A collaborative medical blog started
by Neil Shapiro, MD, ACP Member, associate program director at New
York University Medical Center's internal medicine residency program.
Faculty, residents and students contribute case studies, mystery
quizzes, news, commentary and more.
Interact
MD
Michael Benjamin, MD, ACP member, doesn't accept
industry money so he can create an independent, clinician-reviewed
space on the Internet for physicians to report and comment on the
medical news of the day.
PLoS
Blog
The Public Library of Science's open access
materials include a blog.
White
Coat Rants
One of the most popular anonymous blogs
written by an emergency room physician.
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