Beyond the EHR – What’s Really Going on With Your Patient?

By Renee Petrie | @reneepetrie

A few weeks ago, I read a blog on @KevinMD entitled The story of a man who didn’t feel well.

Once upon a time, not that long ago, there was man who lived an uncomplicated life. One morning he awoke and did not feel well. He could not really describe his malaise, but he definitely was not his usual self. Nothing particularly noteworthy had happened to him except that his dog had recently died of old age…

The story continues to describe the man’s experience booking his first doctors appointment in many years and shares his resulting care journey. Recently, I went to my first check up in quite some time, so I was amused by several parallels — including the automated phone tree, the medical assistant who had her back to me as she asked me personal questions, and (surprisingly!) my elevated blood pressure reading.

The attendant sat with her back to him and asked lots and lots of intimate questions while typing his answers into the computer. Finally, she finished and said the doctor would be with him shortly.

“Well, you certainly need the complete battery of health maintenance screening and additional lab work,” said the doctor. “Have these studies done and I will see you back next week. Here is a prescription to treat your hypertension.” The man went home feeling unhealthier, and his arms hurt from all the vaccinations and blood tests.

 

I didn’t receive a prescription or other follow-up for my blood pressure reading. Instead, my new doctor seemed comfortable writing off the high reading to ‘nerves associated with a new clinic visit’. Did I feel nervous? I didn’t think so at the time. What struck me as strange was they could write this off to ‘nerves’, and yet still expect me to respond honestly to several personal questions, asked just moments after my arrival. In fact, as a researcher, I barely recognized the loosely phrased two-item depression screening questions tossed casually over the shoulder by the medical assistant.

He felt worse than ever despite having all the “best practice” testing.

 

The story continues with the man going through almost an endless series of tests and medications. He has a peculiar dream, and the next morning he follows a road where he encounters a young boy…

“Hey Mister,” called the boy. “Would you like a puppy? I only have one left…

 

That’s right, the man lost his dog of 17 years. Unfortunately, during his initial visit the doctor didn’t inquire into his personal life and what might be making him feel unwell. And, even if they did… as researchers we know it can be difficult to get people to disclose personal information to a stranger, even if they are a doctor. And quite frankly, even if you’ve known your doctor for years, most don’t have the time to dig deeper.

 

What if there was a better way?

What if providers had the ability to ask patients detailed questions – about quality of life, outcomes and risk screeners – without additional staff burden, and act on that information in real-time to deliver better care? Providers have already demonstrated the feasibility of integrating standardized web-based patient questionnaires into routine clinical care. These solutions make it easier to for providers to collect data, assess results in real time, and deliver more personalized care.

And then there is the challenge of getting the patient to answer openly and honestly to questions regarding topics like stress or depression.  In a recent survey of patients with Rheumatoid Arthritis, 61% of patients said they feel uncomfortable sharing their concerns and fears with their doctor.

There is a solution. Providers should incorporate web-based, self-administered questionnaires into routine clinical encounters. Research has shown, this mode increases respondents’ willingness to disclose sensitive information when compared with face-to-face data capture.

It’s simple really. With these standardized, easy-to-administer tools integrated into the clinical encounter, providers can close care gaps, drive deeper engagement, and put into place solutions that will resulting in the best, most useful data to drive better care and better outcomes.

Oh, and in case you’re wondering how things turned out with my doctor’s visit. I’ve monitored my blood pressure and it’s been normal ever since. Maybe I just needed to slow down and take some time to snuggle with my puppy.


Renee2016

Renee helps customers apply DatStat technology solutions across health research and patient-centered population health management.  Before joining DatStat, she spent 17 years in working at nationally recognized research centers. While at University of Washington’s Social Development Research Group (SDRG), she set the standard for maximizing engagement and retention in landmark longitudinal studies. Renee now combines her practical research experience and a fascination with technology to help customers understand how to leverage technology in patient interactions to create ‘sticky’ relationships – ultimately achieving better engagement and outcomes.

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