I have now have some experience with my personal patient portal and, although it is rather rudimentary, I like it very much. I particularly like avoiding the hospital telephone tree when I need to make an appointment with my physician. However, publishing lab test results for patients via such portals will require a lot of hand-holding and explanations (see: Publishing Test Results in Patient Portals: Holding a Tiger by the Tail). Here's a quote from this recent note:
Lab professionals [will] need to continuously monitor and manage how test results are displayed in both the EHR and the patient portal. I am not complaining about patient portals. They provide very useful information for patients that never would have occurred without HITECH and the penalties for non-compliance. All that I am saying is that we will need more lab personnel to monitor these result reporting channels for errors and for the investigation of the causes of such errors.
John, who blogs over at Chilmark Research, took up a similar theme in a recent blog note (see: Struggling to Understand or Data Does Not Equal Empowerment). He received a printed summary after a physician visit. Below is an excerpt from his note in which he discusses his frustration at not being able to interpret the report, particularly the test results:
Recently upon leaving my doctor’s office I was presented with a print-out of my visit summary. Knowing I worked it the HIT space my doctor proudly stated that this was one the ways that they planned to meet one of the menu objectives of Stage One meaningful use (MU). This is great I thought, until I began looking over that visit summary. A significant portion of the summary listed the basics such as who I was, why I paid them a visit etc., all pretty boiler plate – nothing new. Then I turned the page to see the lab results of the routine blood-work – YIKES! nothing but acronyms, values and acceptable ranges. I think I was able to decipher about 10% of those lab results and I work in this industry! I can only imagine how difficult and mind-numbing these figures may appear to an “ordinary” patient/consumer....I want personalization. I want a system that will take my lab results, my problem list, match it up with my meds, allergies etc. and provide me with personalized knowledge of what these results mean to me and my future health. I then want to be provided suggestions as to how to improve those values? This is what I see as true patient/consumer empowerment. Unfortunately, what I have actually experienced as a result of this grand HITECH effort under Stage One falls far short of empowerment, if anything, it is closer to disempowerment. Getting a bunch of data in a visit summary without putting it into context is not meaningful, it is meaningless. My hope is that there are some novel, creative solutions now being developed that will leverage the new concept in Stage Two [of MU]...and provide a module that automatically digs into a patient’s PHI and presents the patient with an empowering visit summary. This is one of the ultimate intents of the HITECH Act, I now want to see it happen.
As I have stated before, lab professionals have not yet totally learned how to present complex lab data to physicians and we are now expected to present such data to patients. I can't state the case more succinctly than John does above: My hope is that there are some novel, creative solutions now being developed that will leverage the new concept in Stage Two [of MU]...and provide a module that automatically digs into a patient’s PHI and presents the patient with an empowering visit summary. I frankly and honestly don't see this occurring quickly. No one seems to be describing the major EHR vendors as particularly innovative (see: EHR Innovation Gap Threatens Healthcare Progress). What is more likely is that there will be an increasing crescendo of criticism of EHRs from both physicians and now patients and the EHR vendors will be forced to improve their game.