EHR and Health IT Consulting
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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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How Patient Access to Doctor Notes Affects Physicians

How Patient Access to Doctor Notes Affects Physicians | EHR and Health IT Consulting | Scoop.it

Releasing physician notes to patients is scary for many doctors. Common concerns include patient misunderstandings regarding the health information included in the note, damaged physician-patient relationships due to the content included, and a flood of questions from patients who are confused about clinical terminology.

But presenters at the Healthcare Information and Management Systems Society (HIMSS) conference in Chicago said it's time to put those concerns to rest.


The presenters, Jan Walker, assistant professor at Beth Israel Deaconess Medical Center and codirector of the OpenNotes initiative; Amy Gleason, chief operating officer at CareSync; and internist Susan Woods, director of patient experience and connected health at the Veterans Health Administration, agreed that providing patients secure online access to physician notes is a win-win for all parties.

Here are three key findings they shared during their presentation:


1. More patients want — and expect — access to physician notes.
During the presentation, Walker shared results from a one-year Open Notes demonstration project funded by the Robert Wood Johnson Foundation. About 100 physicians from Beth Israel Deaconess Medical Center, Geisinger Health System, and Harborview Medical Center participated in the project, affecting more than 13,000 patients in multiple locations.


Jan Walker In the demonstration project, patients received an alert that their note was ready to view as soon as the physician signed the note (and they received another alert prior to patient visits).

Walker acknowledged that one big question prior to starting the project was whether patients would be interested. Ultimately, over the course of the 12-months, 82 percent of patients at Geisinger who had a visit to their provider opened at least one note.


Notably, that included older patients, sicker patients, and less educated patients. In fact, patients with no more than a high school education looked at notes at same rate as everyone else, said Walker.

Ninety nine percent of patients said they wanted to continue having access to physician notes, and 85 percent said availability of physician notes would influence their future choice of providers.


2. Patients report positive results when they can view physician notes.
So what effect did that increased access to physician notes have on patients? The study suggests a positive one. About three-quarters of the survey respondents said they take better care of themselves, understand their health better, feel more in control, take their meds as prescribed at greater rates, and feel better prepared for patient visits, said Walker.


Other positive results Walker said patients reported included:

• Improved recall of the patient visit and improved ability to adhere to follow-up recommendations, because looking at the note helped patients refresh their memory.


• Improved trust between patients and their physicians because it removed the "mystery" of what the physician was writing in the record.

 
• Improved ability of patients to be prepared for their next visit and to engage in shared decision making.


3. Physicians report positive results when patients can view their notes.
While many of the physicians reported concerns regarding how patient access to notes would affect their work flow, very few actually saw these concerns come to fruition, according to Walker.


Only 2 percent reported longer visits, 3 percent reported spending more time on patient questions, and 11 percent reported spending more time on documentation. In fact, Walker commented that a common question received from physicians who were participating in the demonstration was whether the access to physician notes feature was on, because they weren't getting questions from patients about the notes. 


And, contrary to the fear that patients might be confused, unnecessarily worried, or offended by the notes, only one percent to eight percent of physicians reported these problems, said Walker.

Perhaps most telling is that, at the end of the 12-month demonstration, none of the participating primary-care physicians stopped participation, even though that was an option. "We really believe this is the right thing to do," said Walker.


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4 Ways Your Practice Can Benefit from a Mix of Technology and Human Touch

4 Ways Your Practice Can Benefit from a Mix of Technology and Human Touch | EHR and Health IT Consulting | Scoop.it

One of the biggest misnomers about an EHR implementation is that it will replace many of the human elements of your practice. While the EHR can replace some of the tasks and processes that were done by humans, the reality is that EHR software is most powerful when paired with human touch. This concept is infused into our Ideal Medical Practice Workflowwhitepaper and should be infused into every clinical practice.

As we enter 2015, here’s a look at 4 more ways your practice can benefit from a mix of technology and human touch:

1. Rescheduling Patients
One of the biggest forms of lost revenue for a practice comes in not rescheduling patients who missed their appointment. While some of these missed appointments represent low quality patients, many missed appointments happen for a good reason and are an opportunity for more revenue for your practice. Unfortunately, most practices don’t consistently reach out to patients and reschedule their appointment. Along with providing additional revenue for your practice, this extra patient outreach is a great form of customer service that will be appreciated by many of your patients and shared with their friends. While some of the rescheduling can be done using technology like emails and text messages, nothing shows a patient you care about them more than a telephone call about a missed appointment.

2. Complete Eligibility Verification
I’ve written previously about the importance of complete eligibility verification and a quality eligibility verification team. While having the correct eligibility information is always important, I can’t stress how much more important eligibility verification is at the start of a new year. At the start of a new year, patients once again are working to meet their deductible and therefore have a higher patient pay amount. Plus, the new ACA insurance plans means many patients will start the new year off with a new insurance plan. If you don’t have a 100% consistent process for verifying a patient’s eligibility, then you’re office is likely working off of old information which will hamper your ability to collect the correct payment from the patient.

3. Referral Tracking
Not appropriately tracking referrals is a big issue in many practices that can easily be handled with a mix of technology and human follow up. Not tracking these referrals is a big clinical compliance issue for your practice that has the potential to lead to a lawsuit. Along with the potential legal liability, I believe having a dedicated team following up on these orders will become extremely important in the new world of value based reimbursement and ACOs. In this next generation of reimbursement, your payment will depend on your ability to ensure patient compliance with outside referrals.

4. Annual Well Visit Reminders
Annual Well visit reminders are another great way to increase high quality visits to your practice. Many practices convert a regular visit into an Annual Well visit. While this may seem convenient for the patient, it usually means you’re cutting the patient short in the care you could provide them. You just don’t have the time in a sick visit to do a thorough well visit exam as well. Even more important is reaching out to those patients you haven’t seen for a while. It’s incredibly valuable to have a dedicated person or team who identifies all of these patients and sends them a reminder or calls them about their annual well visit. Plus, these annual well visits are a great way to add to your bottom line.

As you look at each of these 4 ways to improve your practice, they all require the right mix of technology and human touch to be done properly. In a busy practice, that can often mean hiring more staff or outsourcing some of these processes to an outside company. Either way, the value created for your practice by implementing these small but important changes will easily offset any additional costs. Plus, you’ll have happier and healthier patients in the process.


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