Increasing Patient Involvement with Their Personal Health Issues

I am a strong advocate of measures that empower healthcare consumers to take more responsibility for their own health. This is one of the key planks in the Health 2.0 movement. One way to achieve this goal is to provide them with accurate health information via the web. Another is by the use of alerts when various preventive and diagnostic services are available for them. Mr. HIStalk makes a key point with regard to such an approach in connection with a program at Kaiser Permanente:

Kaiser Permanente Southern California has the highest rate of breast cancer screening in the country according to an NCQA analysis, crediting KP HealthConnect’s record flagging that allows any KP employee to remind the patient that they can get a no-appointment mammogram or make an immediate appointment. Criticisms aside (cost), it appears that Kaiser is really using its EMR to do some darned interesting things that benefit patients. Once you get the application up to a critical mass of usage, you can put all kinds of value-added functions on top of its data and real-time patient encounters.

I have two comments about this news item. First, I believe that alerts to patients (e.g., phone, letter, email) are effective reminders to take advantage of services. Think about your own reaction when you get a reminder telephone call from your own medical or dental office. As noted above, the EMR provides a means to generate such alerts that can be initiated by "any KP employee." In the case of personal health records (PHRs) tethered to an EMR, there is an opportunity for more personal patient engagement in the process.

Note also that Mr. HIStalk quickly glosses over what some may consider a "negative" of health alerts -- the increased costs associated with preventive health services. As the cost of healthcare continues to mount, there will be reminders from some about the overutilization of services by consumers who have health insurance policies with all of the bells and whistles. However, I suspect that few of such critics would object to mammograms performed at the recommended intervals. The value of such testing was definitively proved in 2002 (see: New Lancet Report and NCI Endorse Mammography). Here the conclusion reached at that time:

A new look at the most widely accepted evidence on the value of mammography has concluded that it cuts breast cancer deaths by more than half in women 55 and older, and by almost one-third in women 45 to 54....