Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

E-Patient Update: Patient-Doctor Communication Still Needs an Update

Posted on December 2, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A few weeks ago, I called my PCP’s after-hours line to address an urgent medical concern. The staff at the answering service took my name, reached out to the doctor on call and when he was ready, connected him to me.

While this procedure was entirely standard, as always I found it a bit offputting, as to me it implies that I can’t be trusted to use the doctor’s cell phone number with some discretion. Don’t get me wrong, part of me understands why the doctors in this practice preferred to preserve their privacy and select when they want to speak to patients. On the other hand, however, it makes me uneasy, as I already have a very superficial relationship with my PCP and this approach doesn’t help.

While this is very much an old-school problem, to me it points to a larger one which has largely gone unnoticed as we plunge forward with the evolution of health IT. In theory, we are living in a far more connected world, one which puts not only family and friends but the professionals we work with on far more of a one-to-one basis with us. In practice, however, I continue to feel that patient-doctor communication has benefited from this far less than one might think.

I know, you’re going to point out to me how many doctors are using portals to email with patients these days, and how some even text back and forth with us. I’ve certainly been lucky enough to benefit from the consideration of providers who have reached out via these channels to solve urgent problems. And I know some health organizations — such as Kaiser Permanente — have promoted a culture in which doctors and patients communicate frequently via its portal.

The thing is, I think Kaiser’s experience is the exception that proves the rule. Yes, my doctors have indeed communicated with me directly via portals or cell. But the email and text messages I’ve gotten from them are typically brief, almost pointillistic, or if longer and more detailed, typically written days or even weeks after the original request on my end. In other words, these communications aren’t a big improvement over what they could accomplish with an old-fashioned phone call – other than being asynchronous communication that doesn’t require we hook up in real-time.

In saying this, I’m not faulting the clinicians themselves. Nobody can communicate with everyone all the time, particularly doctors with a large caseload. And I’m certainly not suggesting that I expect them to be Facebook buddies with me and chat about the weather. But it is worth looking at the way in which these communication technologies have seemingly failed to enrich the communication between patient and doctor in many cases.

Until we develop a communication channel for patients and doctors which offers more of the benefits of real-time communication — while helping doctors manage their time as they see fit — I think much of the potential of physician-patient communication by Internet will be wasted. I’m not sure what the solution is, but I do hope we find one.

Portals May Not Reduce Calls To Medical Practices

Posted on November 16, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Initially, patient portals were rolled out to give patients access to their core medical information, with the hope that a more educated patient would be more likely to take care of their health. Over time, features like appointment setting and the ability to direct-email providers were added, with some backers predicting that they would make practices more efficient. And since providers began rolling out nifty new interactive portals, anecdotes have piled up suggesting that they are delivering the goods.

However, a new study suggests that this might not be the case — or at least not always. The researchers behind the study, published in the Journal of the American Board of Family Medicine, had predicted that when patients got access to a full-featured portal, clinic staffers’ workload would be cut. But they did not achieve the results they had expected.

The researchers, who were from the Oregon Health & Science University in Portland, compared portal adoption rates and the number of telephone calls received at four clinics affiliated with a university hospital between February and June 2014.

They found that despite growing adoption rates of the portal at all four clinics, call volumes actually increased at two of the clinics, which included a commercial, community-based health center and a university-based health center. Meanwhile, call volume stayed level at the two other clinics, a rural health center and a federally-qualified health center. In other words, in no case did the volume of phone calls fall.

The researchers attempted to explain the results by noting that it might take a longer time than the study embraced for the clinics to see portals reduce their workload. Also, they suggested that while the portal didn’t seem to reduce calls, it might be offering less-concrete benefits such as increased patient satisfaction.

What’s more, they said, the study results might have been impacted by the fact that all four clinics were implementing a patient centered medical home model. They seemed to think that PCMH requirements for care coordination and quality improvement initiatives for chronic illness, routine screenings and vaccinations might have increased the complexity of the patients’ needs and encouraged them to phone in for help.

As I have noted previously, patients seldom see your portal the way you do. In that previous article, I described my largely positive — but still somewhat vexing – experience using the Epic MyChart portal as a patient. In that case, while I could access all of the data held within the health system behind the EMR pretty easily, getting the health system employees to integrate outside data was a hassle and a half.

In the case described in the study, it sounds like the portal may not have been designed with patient workflow in mind. With the practices rolling out a patient-centered medical home model, the portal would have to support patients in activities that went well beyond standard appointment setting and even email exchanges with clinicians. And presumably, it didn’t.

Bottom line, I think it’s good that this research has led to questions about whether portals actually make make medical practices more efficient. While there is plenty of anecdotal evidence suggesting that they do — so much that investing in portals still makes sense — it’s good to see questions about their benefits looked at with some rigor.

Consider The Portable EMR

Posted on October 19, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The other day I was reading the Huffington Post, and was surprised to stumble across a rather interesting article promoting the benefits of a “portable” EMR. Now, for HIT fans like ourselves, the word portability implies having data travel from one provider directly to another in a usable manner. But author David Black, who describes himself as a “software guy” and Technology Partner at Oak HC/FT, has something different in mind.

For Black, the best way to share healthcare data would be if the patient carried it around from place to place and updated it as they travel from provider to provider. To be more specific, the portable EMR is an app with all of the patient’s healthcare data and history stored in it. The app would serve the purpose Microsoft Outlook does for email, with the data stored and backed up in the cloud, available to sync to any device.

As Brown sees it, not only would this be a way to keep data at patients’ fingertips, it would be a better way to control access to PHI as well. As he notes, many apps ask permission to access data such as email contacts. In this case, the app would ask permission before sharing the data with medical professionals. None of the data would be “locked up” in an EMR, he says.

Now, while I’m intrigued by this idea, I can see several problems that would result from wide adoption of this approach, including the following:

* Safety and security of the data stored in the cloud:  I’m no legal expert, but from what I’ve read about the healthcare cloud, any cloud vendor with which a provider works must be a full Business Associate under HIPAA, and meet the data security standards involved. I doubt many cloud services chosen by a consumer are in compliance, and that needs to be resolved before these become too popular.

* Securing of the consumers’ data:  Ok, let’s say that the cloud-based backup arrangements were kosher. Live ePHI is still resident (and probably quite hackable) on the consumer device which contains the EMR portability app. How can consumers protect it adequately, and if they don’t what happens to systems within the provider organization that access it?

* Carrying the device:  Even if the consumer data in the portability app is secure both in the cloud and on the device, that device still has to travel with the patient. No one wants to carry a laptop everywhere, smartphones and tablets have usability issues and other devices come with their own questions. Also, if the patient’s phone or laptop gets smashed in a car wreck, but providers need current health data to treat them, where do they get it?

Despite these complaints, I do see the benefits of Brown’s approach. Putting portability into the patients’ hands has not only accessibility benefits, but also stands to boost patient engagement. (And in fact, I know of at least one company – full disclosure, a client – that’s actually doing something along these lines.) But the model that Brown is proposing has many challenges to address.

Providers Often Choose Low-Tech Collection Solutions

Posted on October 6, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As most providers know, it’s harder to collect money from the patient once they’ve walked out the door. This has always been an issue, but is particularly important today given that patients are being asked to bear an increasingly larger percentage of their healthcare bill.

In some cases, providers solve this problem by having their staff reach out directly via phone, rather than relying entirely on paper billing. Others address these issues with technology solutions such as offering payment options via a web portal. And of course, some providers do both.

But the question remains, which combination is most likely to boost collections efficiently without losing patients in the process? And it’s this question, which underlies all those other considerations, which a new study hopes to address. When reading the results, it’s good to bear in mind that the sponsor, BillingTree, is a payment technology firm and therefore has a bias, but the survey data was interesting nonetheless.

First, a look at providers’ collections challenges. Respondents told BillingTree that compliance and collecting payments once the patient has left the building were concerns, along with knowing the correct amount to bill after insurance and addressing the client’s ability to pay. Perhaps the biggest issues were a lack of payment channels – be they staffers, interactive voice response or website tech — and disputes over the amount billed.

According to BillingTree researchers, few respondents were using Web or automated phone payment collection technologies to bring in these missing dollars. While 93.9% accepted online and mail payments, and 86.7% said they accepted payments over the phone via a live agent, only 66.7% provided a web portal payment option, and just 6.7% offered the ability to pay via an interactive voice response system. Rather than add new technologies, respondents largely said that they intended to improve collections by adding staff members or outsourcing part of their collection operations.

On the other hand, technology plays a somewhat bigger part in providers’ future plans for collections. Over the next 12 months, 20% said they planned to begin accepting payments via a web portal, and 13.3% intend to add an IVR system to accept payments. Meanwhile, the 26.7% of providers who are planning to outsource some or all of their collections are likely to benefit indirectly from these technologies, which are common among payment outsourcers, BillingTree noted.

Among those providers that did offer phone or web-based payment options, one-fifth chose to add a convenience fee to the transaction. BillingTree researchers noted that given the low adoption of such technologies, and concerns about regulatory compliance, such fees might be unwise. Nonetheless, the data suggest that collection of such fees increase over time.

All this being said, the BillingTree study doesn’t look at perhaps the most critical technology issue providers are struggling to address. As a recent American Medical Association survey recently concluded, providers are quite interested in tools that link to their EMR and help them improve their billing and reimbursement processes.

Focusing on revenue cycle management issues at the front end of the process makes sense. After all, while patients are being forced to take on larger shares of their medical costs, insurers are still more reliable sources of income. So while it makes sense for providers to track down patients who leave without having paid their share of costs, focusing the bulk of their technology dollars on improving the claims process seems like a good idea.

E-Patient Update: A Bad Case Of Hyperportalotus

Posted on September 30, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Lately, the medical profession has seen an increasing incidence of a new condition tentatively identified as “hyperportalotus” — marked by symptoms of confusion, impatience, wasted time and existential dread. Unlike many newly-identified medical problems, the cause for this condition is well understood. Patient simply have too many portals being thrust at them.

As a patient with a few chronic illnesses, I see several specialists in addition to a primary care doctor. I’ve also been seen recently at a community hospital, as well as an urgent care center run by a different health system. I have access to at least seven portals, each, as you probably guessed, completely independent of each other.

Portals in play in my medical care include two instances of Epic’s MyChart, the Allscripts FollowMyHealth product and an athenahealth portal. (As an aside, I should say that I’ve found that I like athenahealth’s product the most, but that’s a story for another day.)

Because I am who I am – an e-patient dedicated to understanding and leveraging these tools – I’m fairly comfortable working with my providers on this basis. I simply check in with the portal run by a given practice within a few days of my visit, review reports and lab results and generally orient myself to the flow of information.

Too Much Information
So, if I can easily access and switch between various portals, what’s the big deal? After all, signing up for these portals is relatively simple, and while they differ in how they are organized, their interfaces are basically the same.

The problem is (drumroll…) that most patients aren’t like me. Many are overwhelmed by their contact with the medical system and feel reluctant to dig into more information between visits. Others may not feel confident that they understand the portals and shy away reflexively.

Take the case of my 70-something father. My dad is actually pretty computer-savvy, having worked in the technology business for many years. (His career goes all the way back to the days of punch cards.) But even he seems averse to signing up for MyChart, which is used by the integrated health system that provides all of his inpatient and outpatient care.

Admittedly, my father has less contact with doctors and hospitals than I do, so his need to review medical data might be less than mine. Nonetheless, it’s a shame that the mechanics of signing up for and using a portal are intimidating to both he and my mother.

A Common Portal
All this being said, the question is what we can do about it. I have a theory, and would love to know what you think of it.

What if we launched an open source-based central industry portal to which all other portals could publish basic information?  This structure would take proprietary vendors’ interest in controlling data out of the picture. Also, with the data being by its very nature limited (as consumers never get the whole tamale) it would answer objections by providers who feel that they’re giving away the store with the patient data.

Of course, I can raise immediate and powerful objections to my own proposal, the strongest of which is probably that we would have to agree on a single shared standard for publishing this data to the central megaportal. (And we all know how that usually works out.)

On the other hand, such approach has much to recommend it, including better care coordination and hopefully, stronger patient engagement with their health. Maybe I’m crazy, but I have a feeling that this just might work. Heck, maybe my father would bother looking at his own medical information if he didn’t have to develop hyperportalotus to do it.

E-Patient Update:  Keeping Data From Patients Has Consequences

Posted on September 20, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Given who I am – an analyst and editor who’s waist-deep in the health IT world – I am primed to stay on top of my health data, including physician notes, lab reports, test results and imaging studies. Not only does it help me talk to my doctors, it gives me a feeling of control which I value.

The thing is, I’m not convinced that most physicians support me in this. Time and again, I run into situations where I can’t see my own health information via a portal until a physician “approves” the data. I’ve written about this phenomenon previously, mostly to wring my hands at the foolishness of it all, but I see the need to revisit the issue.

Having given the matter more thought, I’ve come to believe that withholding such data isn’t just unfortunate, it’s harmful. Not only does it hamper patients’ efforts to manage their own care effectively, it reveals attitudes which are likely to hold back the entire process of transforming the health system.

An Example of Delayed Health Data
Take the following example, from my own care. I was treated in the emergency department for swelling and pain which I feared might be related to a blood clot in my leg. The ED staff did a battery of tests, including an MRI, which concluded that I was actually suffering from lumbar spine issues.

Given that the spinal issue was painful and disabling, I made an appointment for follow up with a spine specialist for one week after the ED visit. But despite having signed up with the hospital’s portal, I was unable to retrieve the radiologist’s report until an hour before the spine specialist visit. And without that report the specialist would not have been able to act immediately to assist me.

I don’t know why I was unable to access the records for several days after my visit, but I can’t think of a reason why it would have made sense to deprive me of information I needed urgently for continued care. My previous experience, however, suggests that I probably had to wait until a physician reviewed the records and released them for my use.

Defeating the Purpose
To my way of looking at things, holding back records defeats the purpose of having portals in the first place. Ideally, patients don’t use portals as passive record repositories; instead, they visit them regularly and review key information generated by their clinical encounters, particularly if they suffer from chronic illnesses.

It’d be a real shame if conservative attitudes about sharing unvetted tests, imaging or procedure data undercut the benefits of portals. While it’s still not entirely clear how we’re going to engage patients further in managing their health – individually or across a population – portals are emerging as one of the more effective tools we’ve got. Bottom line, patients use them, and that’s a pretty big deal.

I’m not saying that patients have never overreacted to what looked like a scary result and called their doctor a million times in a panic. (That seems to be the scenario doctors fear, from conversations I’ve had over time.) But my guess is that it’s far less common than they think.

And in their attempts to head off a minor problem, they’re discouraging patients from getting involved with their care, which is what they need patients to do as value-based care models emerge. Seems like everyone loses.

Sure, patients may struggle to understand care data and notes at first, but what we need to do is educate them on what it means. We can’t afford to keep patients ignorant just to protect turf and salve egos.

Building a Usable Healthcare API

Posted on August 31, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve long believed that a rock solid API is going to be required by healthcare IT software companies and EHR vendors in particular. If we want hospitals and doctors to be able to accomplish everything they need to accomplish, we need APIs to connect providers to services that will better serve the patients. EHR vendors aren’t going to do everything. With this in mind, we thought that it was time to start a discussion on how to build a usable healthcare API.

On Thursday, September 8th at 3:30 PM ET (12:30 PM PT), join us LIVE in our latest Healthcare Scene interview, as we discuss healthcare APIs with the following experts:

2016 September - Building a Usable Healthcare API-Headshots
There are a lot of people who talk generally about an API, but very few that have executed it well in healthcare. CareCloud and ManaHealth are two healthcare companies that are trying to implement a health care API in the right way, so we’re excited to sit down with them to talk about their experience building healthcare APIs.

If you’ve never watched one of our live video interviews, you can watch it live on this YouTube page (includes Live Chat room as well) or just visit this post on the day of the event and watch the video embedded below:

We look forward to shedding more light on what it takes to build a high quality, usable healthcare API.

Be sure to Subscribe to Healthcare Scene on YouTube to be updated on our future interviews or watch our archive of past Healthcare Scene Interviews.

Duplicate Work in Healthcare

Posted on July 7, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of my favorite stories is the time we implemented an EHR in the UNLV health center. At first, we decided to do a phased implementation in order to replace some legacy bubble sheet software that was no longer being supported. So, we just implemented enough of the PM system to handle the patient scheduling and to capture the charge data in the EHR. Of course, we were also a bit afraid if we implemented the full EHR, the staff would revolt.

A week or two into the partial implementation, something really amazing happened. First, some of the providers started to document the patient visit in the EHR even though they still had to document it in the paper chart as well. I asked them why and they just said, “It was there and I thought it would be good to have my info in the note.”

Second, some of the providers started asking me why they had to do duplicate work. They really hated having to enter the diagnosis and charge codes into the EHR and then document them again in the paper chart. Plus, they followed up that they could see the other section of the notes in the EHR and “why couldn’t they just use that instead of the paper chart.” The reality was: Doctors hated doing duplicate work!

Once I heard this, I ran to the director of the Health Center’s office and told her what they’d said. We both agreed, why wait? A week or so later we’d moved from paper charts to a full EHR implementation.

There were a lot of lessons learned from this experience. First, it’s amazing how people want to use the new system when they can see that it’s possible. They basically drove the EHR implementation forward. However, what was interesting to me was the power of “duplicate work.” We all hate it and it was a driving force for using technology the right way.

While we used the concept of duplicate work for good, there’s a lot of duplicate work in healthcare which drives patients and healthcare staff totally nuts. However, we don’t do anything about it. This was highlighted perfectly in a recent e-Patient update from Anne Zieger. Go and read her full account. We’ll be here when you get back.

What’s astounding from her account is how even though doctors hate duplicate work for themselves, we’re happy to let our patients and support staff do duplicate work all the time. I’ve seen some form of Anne’s experience over and over. Technology can and should solve this. This is true across multiple clinics but is absolutely true in the same clinic where you handle the workflow.

I get that there are reasons why you may want a staff to verify a patient’s record to ensure it was entered correctly and is complete. That’s absolutely understandable and would not have likely been an issue for Anne. However, to disregard the work a patient had done on their intake paperwork is messed up. Let alone not tapping into a patient’s history that may have been entered at another clinic owned by the same organization or collecting/updating the info electronically through a patient portal. I’m reminded of @cancergeek’s recent comment about the excuse that “it’s how we’ve always done it.”

In the past this might not have mattered too much. Patients would keep coming back. However, the tides of consumerism in healthcare are changing. Do you enjoy doing duplicate work? Of course not! It’s time to purge duplicate work for patients and healthcare staff as well!

Providers: Today’s Telehealth Tech Won’t Work For Future

Posted on July 5, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study has concluded that while healthcare leaders see major opportunities for growing their use of telehealth technologies, they don’t think existing technologies will meet the demands of the future.

For the study, which was sponsored by Modern Healthcare and Avizia, researchers surveyed more than 280 healthcare executives to see how they saw the future of telehealth programs and delivery models. For the purposes of the study, they defined telehealth as encompassing a broad mix of healthcare approaches, including consumer-focused wireless applications, remote monitoring of vital signs, patient consultations via videoconferencing, transmission of still images, use of patient portals and continuing medical education.

The survey found that 63% of those surveyed used telehealth in some way. Most respondents were with hospitals (72%), followed by physician groups and clinics (52%) and a grab bag of other provider organizations ambulatory centers in nursing homes (36%).

The most common service lines in use by the surveyed providers included stroke (44%), behavioral health (39%), staff education and training (28%) and primary care (22%). Other practice areas mentioned, such as neurology, pediatrics and cardiology, came in at less than 20%. Meanwhile, when it comes to telehealth applications they wish they had, patient education and training was at the top list at 34%, followed by remote patient home monitoring (30%) and primary care (27%). Other areas on providers’ wish lists include cardiology (25%), behavioral health (24%), urgent care (20%) and wound care (also 20%).

Not only did surveyed providers hope to see telemedicine extended into other service lines, they’d like to see the technologies used for telehealth delivery change as well. Currently, much telehealth is delivered via a computer workstation on wheels or ‘tablet on a stick.’  But providers would like to see technology platforms advance.

For example, 38% would like to see video visits with clinicians supported by their EMR, 25% would like to offer telemedical appointments through a secure messaging app used by providers and 23% would like to deliver telemedical services through personal mobile devices such as tablets and smartphones.

But what’s driving providers’ interest in telehealth? For most (almost 75%) consumer demand is a key reason for pursuing such programs. Large numbers of respondents also cited the ability to improve clinical outcomes (66%) and value-based care (62%).

That being said, to roll out telehealth in force, many respondents (50%) said they’d have to make investments in telehealth technology and infrastructure. And nearly the same number (48%) said they’d have to address reimbursement issues as well. (It’s worth mentioning, however, that at the time the study was being written, the number of states requiring reimbursement parity between telehealth and traditional care had already risen to 29.)

This study underscores some important reasons why providers are embracing telehealth strategies. Another one pointed out by my colleague John Lynn is that telehealth can encourage early interventions which might otherwise be delayed because patients don’t want to bother with an in-person visit to the doctor’s office. Over time, I suspect additional benefits will emerge as well. This is such an exciting use of technology!

E-Patient Update: Apple Offers iPhone EMR Access

Posted on June 22, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Over the last few years, Apple has steadily beefed up the health data access provided by its iPhone operating system, in ways that have made some sense. But depending on how consumers react, its latest effort may have the biggest impact of all of its data sharing efforts to date.

In its latest mobile operating system, Apple is allowing users to store their EMR data directly in its Health app, using the HL7 CCD standard. And while this isn’t a huge step forward for interoperability, it does give e-patients like me a greater sense of control, which is definitely a good thing.

In recent years, Apple has made increasingly sophisticated efforts to unify healthcare data. Perhaps the highest profile effort is the summer 2014 launch of HealthKit, a healthcare data integration platform whose features include connecting consumer-generated data with traditional clinical sources such as the Epic EMR.

Meanwhile, it has steadily added capabilities to the Health app, which launched with iOS 8. Since then, it has been encouraging consumers to manage health data on their phone using HealthKit-enabled apps like the Epic MyChart patient portal app. The new EMR data retrieval function is available in the iOS 10 version of Health.

According to Apple blog 9to5Mac, consumers can import the CCD data from Mail, Safari and other applications as well as into Health. When consumers add the CCD file to Health, the app opens and providers a quick preview of the document’s data, including the healthcare provider’s name, patient’s name and document owner’s name. It also identifies the document’s custodian. Once downloaded, the device stores the document in encrypted form, indefinitely.

Also, when a user confirms that they want to save the record to the Health app, the CCD info is added to a list of all of the health record documents stored in the app, making it easier to identify the entire scope of what a user has stored.

Looked at one way, the addition of medical record storage capabilities to the latest iOS release may not seem like a big deal. After all, I’ve been downloading broad swaths of my healthcare data from the Epic MyChart app for a couple of years now, and it hasn’t rocked my world. The document MyChart produces can be useful, but it’s not easily shareable. How will it change patients’  lives to store multiple records on their cell phone, their tablet or heaven help us, their Apple Watch?

On the surface, the answer is almost certainly “not much,” but I think there’s more to this than meets the eye. Yes, this solution doesn’t sound particularly elegant, nor especially useful for patients who want to share data with clinicians. My guess is that at first, most consumers will download a few records and forget that they’re available.

However, Apple brings something unique to the table. It has what may be the best-integrated consumer technology base on the planet, and can still claim a large, fanatical following for its products. If it trains up its user base to demand EMR data, they might trigger a cultural shift in what data patients expect to have available. And that could prove to be a powerful force for change.