From the July 2016 issue

Health Care Goes Digital

Forget the sea of paper charts. Today, the medical community is going modern, with patient portals, digital doctor appointments and email communication.

Doctors’ offices have come a long way from paper calendars to schedule appointments and the walls and walls of patient files. Now, prescriptions are sent to the pharmacy from the exam room, patient records are available from anywhere and doctors are making house calls via video conference software.

For many local families, it’s already the norm. That’s thanks partly to a federal nudge. As of 2014, heath care providers earned financial incentives for proving “meaningful use” of electronic health records – things like boosting quality and safety, engaging patients and improving care coordination.

This digital record evolution certainly brings new challenges and demands. Still, the move is expected to increase customer satisfaction and create a higher level of patient care. Here’s what you and your family can look forward to as medical care continues to go digital.

Patient-centered services

Bill Brothers started using Beaumont Health‘s myBeaumontChart a year ago when his doctor introduced him to it during a routine physical.

“She said she was a fan of the portal and would post all of the test results there, along with any comments she had,” says Brothers, a Clinton Township dad of two sons, ages 5 and 7. After the tests were completed, Brothers was able to get his results right away and respond to his doctor’s comments through the portal messaging system, much like email. Brothers didn’t have to call for results, wait for a recommendation or delay any action on his end. It’s been useful other times as well.

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“My doctor needed to adjust my blood pressure medicine recently and asked me to track (it) for several days and send her the results through the portal. I’ve also used it to reach out to her for clarification on treatments and procedures,” he says. “Before, if I had questions, I would either have to make an appointment or call into the office and wait for the doctor to call back. I don’t have to worry about missing her call or waiting until she has time to make the call. I think it’s easier for her to respond electronically, as well.”

Kristin Orlick of St. Clair Shores maintains a digital record of her life. From the photos on her phone to the updates on Facebook, a digital copy of her life is available whenever and wherever she needs it. She says the same should be true for her medical records.

Orlick is president and owner of KO Consulting, a national firm that specializes in helping physician practices set up and use electronic medical records as well as to navigate the government programs aimed at encouraging doctors to use electronic medical records. She helps medical offices meet the needs of their patients.

“As a technically savvy parent, I wouldn’t take my family to a group that didn’t have electronic access or portal capabilities. I’m on the road working so much, I can’t be at every one of my daughter’s doctor appointments. So, by having the portal, I’m still connected. I have access,” says Orlick, whose child is 7. “I can message and request appointments even after the office is closed, which is huge for me.”

Caring for her father, a Veterans Affairs hospital patient, is easier with the digital recordkeeping services the VA uses.

“He has a portal. I’m able to keep him reminded about appointments and information, and update the rest of my family on his health without always being at the appointments,” Orlick says.

While Brothers and Orlick are young parents, they aren’t the only patients asking for the access or using the information. Jennifer Tucciarone, a family medicine specialist with Beaumont Health System, says her elderly patients may even use it more than some of the younger patients.

“Through myChart access, the patient can see a majority of their records, immunization records and when health maintenance items are due,” she says. “It allows them to request refills on medication, and they can send messages to the practice, including straight to the physicians.”

It also isn’t just the young doctors providing such services. Orlick says she recently worked with a 65-year-old surgeon who embraced the move to digital.

“This doctor struggled at first with the new system, but he refused to give in. He dug in and worked so hard to get comfortable with the electronic medical record,” Orlick says. “When I asked him why he embraced this change, he compared it to learning new surgical techniques. He said if you are unwilling to change and learn new things, you will become obsolete.”

Knowledge is power

It isn’t just the patients who benefit from the connectedness. The doctors are seeing a shift in patient care since the introduction of digital records.

“We live in a digital age. In terms of the medical field over the past 10 years, there have been huge changes. There is a push for all physicians to go electronic,” says St. John Providence physician Basil Abdo, who works out of various southeast Michigan locales. “The goal is that when we use that advanced technology, it’s going to help with the quality of care.”

With digital records, Abdo says even the simplest of errors, such as allergies to particular types of medication, should be identified easier.

Tucciarone says portals enhance the doctor-patient communication.

“We often ask patients to follow up with us and call and let us know how they are doing, and they don’t always do it,” she says. “We have found if they can just send us a message and let us know things are going well, they often will do that.”

Tucciarone adds that digital records also provide for a better transition of care.

“A lot of times, the patient has to repeat information from doctor to doctor. These digital records allow us to be more efficient, and we definitely get fewer phone calls. It helps with continuity,” says Tucciarone.

In her practice, Tucciarone says the on-call doctor changes from week-to-week. Having access to digital records on their mobile devices provides doctors the ability to look at patient records, even for those who see another physicians in the practice, and treat them accordingly.

Doctors of different specialties, particularly those within the same health systems, are finding it easy to share information too. However, the technology between hospital systems is still a work-in-progress.

“If you are in the same hospital system, it’s easy to look up the information. All of these systems are not talking to each other, however. That’s a huge challenge,” Abdo says. “If I’m in the Providence system and my patient saw someone in the Beaumont system, we may not be able to see the information we need.”

The portals are a secure way to exchange information, Orlick notes. She says the government requires the doctors’ offices to adhere to strict security regulations and yearly security risk assessments.

“As a patient, I’m just as comfortable with this as I am with the old processes,” Orlick says.

Increased workload

With technology and the increased demand for immediate results, many professions have become 24-hour operations, and the medical field is not immune. With the advances in technologies, some doctors offices need additional staff to help make it all run smoothly and provide answers and help to their patients.

“Some doctors are being stressed out and burned out from the technology. It’s taking them a few extra hours every day to do their notes, respond to messages and handle the additional responsibilities,” says Abdo.

Orlick says she sees office across the country handle the increased workload in different ways.

“Usually there is a front line of people triaging the messages and sending them to the appropriate staff for answering. In some offices, the messages are sorted and distributed by the type of message sent through the portal. In other offices, the doctors intercept the message and respond themselves,” Orlick says. In most cases, she adds, it’s not about finding more staff or working longer hours; it’s about repurposing the traditional roles. “Instead of manning the phones, the staff is manning the portal.”

Tucciarone says her office has computers in all of the examine rooms so they can interact with patients and enter the information as they meet with them, but a lot of the other tasks are completed between appointments and during scheduled time.

“We anticipated there would be a lot more follow up with patients, but we have managed,” says Tucciarone. “I think it’s a little bit easier to get the test results to the patient through the portal. There are no results letters to mail or calls to make.”

Digital doctors

At Tucciarone’s office, the doctors started offering e-visits, or video visits via the computer, with their patients.

“We’re a very busy practice and there are some days when we are out of appointments and have a hard time getting some patients in. By having the capability to email or do an e-visit, it eases the access problem,” she says.

Like any other appointment, her e-visits are scheduled, but instead of taking place in a room face-to-face, Tucciarone is often in her office, using video conferencing software to meet with her patient. Tucciarone says the e-visits work well for urgent care-type topics such cold symptoms, urinary tract infections and other conditions that can be treated from afar.

Abdo says he’s not using virtual appointments quite yet, but he does see how they can be useful.

“I can see it working in more rural areas where there is a shortage of physicians or medical providers,” he says, “but in a city like this, it’s always good to have face-to-face appointments.”

For Abdo, it’s harder to diagnose things like ear infections via a video chat, but he does see the portal as being a useful tool for communicating.

“I would encourage the patient to use the portal and say ‘What can I do for this? Should I bring my child in immediately or can it wait for tomorrow?’ Use the portal to ask the questions and start the diagnosis of the problem.”

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