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The e-Patient of the 21st Century: How Digital Tools Foster the Patient/Physician Partnership by Empowering, Engaging and Educating

I recently spoke at the Medical Informatics World Conference where I discussed how a digital tool-kit is now available to help patients and physicians communicate consistently, coordinate patient care among all of the individual’s providers and ensure continuity of care over the long-term.

I talked about how electronic health records are the fundamental core for gathering all of a patient’s information in one place and having it available to all of the patient’s providers on the health care team. It has been a long journey from the paper-based health care system that existed only a few years ago, to this point, where a robust digital record that includes full data capture and sharing, and patient access to the summary notes of the healthcare encounter, changes the health care delivery system.

One of the important tools that will foster this new dynamic of patient care is Open Notes, a national initiative to give patients access to the visit notes written by their providers. Open Notes which has many early adopters, including  Geisinger, Kaiser Permanente, and the Beth Israel Deaconess Medical Center, allows individuals to securely access their  health information and share it with health care providers, caregivers and others they trust.

Blue Button, which was designed by the VA, enables patients to securely  view online and download their health record to their computer, tablet, thumb drive or smart phone, without special software. Supported by several Federal agencies, health plans and vendors of personal health records, Blue Button makes it possible for the patient to have control of their full information at the point of care and share it with others who have the need to know.

Other digital tools in the kit include email which fosters ongoing communication between patients and providers because it is immediate; available; 24/7; enables communication from anywhere, at any time; and eliminates the time constraints of traditional patient/physician communication.

Patient portals, secure online web sites which encourage patients’ direct involvement in their care, enabling them to access lab and procedure results, get referrals, renew prescriptions, and easily connect to educational materials.  In this way they help patients manage some of the details of their care and cut down on unnecessary office visits.  They also help  providers save time  when they use the portal as a secure messaging forum where they can post reminders to patients (e.g. get your flu shot), or post patients’ results and automatically schedule a call or an online visit.

The sheer volume of health information, most of which resides on the Internet, changes the dynamics of health information dissemination.  The Web is  another powerful tool that empowers patients and providers by supplying  appropriate resources for patients to find viable data about health issues and connect with other patients on social health networks.  The Web is also where  providers can   access the information to insure  that they are deploying evidence-based medicine and best practices at all times.

Mobile Health/cell phones are available today to 98% of the world’s population. There are 6 billion mobile subscriptions worldwide.  Even in the most remote parts of the world, people are sending and receiving text messages via Short Message Systems  (SMS) about many health issues, using their cell phones.  Additionally, there are thousands of  health apps for smartphones, including an electronic stethoscope, heart monitors, screening devices for vital health information and the popular apps that  track exercise, fitness, weight and diet.

Wearable devices have also emerged as part of the tool kit that engages and empowers patients to be in charge of their health.  With embedded sensors, these devices, which include hats, shirts, mats, wrist bands, shoes, Velcro straps, watches and even the Google Glass help patients  monitor their chronic conditions  for safer medical practice.

The E-Patient of the 21st century






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