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E-Patient Update: Hey Government, Train Patients Too!

Posted on February 10, 2017 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.

Recently I got a most interesting email from the ONC and A-list healthcare educator Columbia University. In the message, it offered me a free online course taught by Columbia’s Department of Biomedical Informatics, apparently paid for by ONC funding. (Unfortunately, they aren’t giving away free toasters to students, or I definitely would have signed up. No wait, I’m sorry, I did register, but I would have done it faster for the toaster.)

The course, which is named Health Informatics For Innovation, Value and Enrichment) or HI-FIVE, is designed to serve just about anyone in healthcare, including administrators, managers, physicians, nurses, social workers an care coordinators. Subjects covered by the course include all of the usual favorites, including healthcare data analytics, population health, care coordination and interoperability, value-based care and patient-centered care.

If I seem somewhat flippant, it’s just because the marketing material seemed a little…uh…breathlessly cheery and cute given the subject. I can certainly see the benefits of offering such a course at no cost, especially for those professionals (such as social workers) unlikely to be offered a broader look at health IT issues.

On the other hand, I’d argue that there’s another group which needs this kind of training more – and that’s consumers like myself. While I might be well-informed on these subjects, due to my geeky HIT obsession, my friends and family aren’t. And while most of the professionals served by the course will get at least some exposure to these topics on the job, my mother, my sister and my best girlfriend have essentially zero chance of finding consumer-friendly information on using health IT.

Go where the need is

As those who follow this column know, I’ve previously argued hard for hospitals and medical groups to offer patients training on health IT basics, particularly on how to take advantage of their portal. But given that my advice seems to be falling on deaf ears – imagine that! – it occurs to me that a government agency like ONC should step in and help. If closing important knowledge gaps is important to our industry, why not this particular gap. Hey, go where the need is greatest.

After all, as I’ve noted time and again, we do want patients to understand consumer health IT and how to reap its benefits, as this may help them improve their health. But if you want engagement, folks, people have to understand what you’re talking about and why it matters. As things stand, my sense is that few people outside the #healthit bubble have the faintest idea of what we’re talking about (and wouldn’t really want to know either).

What would a consumer-oriented ONC course cover? Well, I’m sure the authorities can figure that out, but I’m sure education on portal use, reading medical data, telemedicine, remote monitoring, mobile apps and wearables wouldn’t come amiss. Honestly, it almost doesn’t matter how much the course would cover – the key here would be to get people interested and comfortable.

The biggest problem I can see here is getting consumers to actually show up for these courses, which will probably seem threatening to some. It may not be easy to provoke their interest, particularly if they’re technophobic generally. But there’s plenty of consumer marketing techniques that course creators could use to get the job done, particularly if you’re giving your product away. (If all else fails, the toaster giveaway might work.)

If providers don’t feel equipped to educate patients, I hope that someone does, sometime soon, preferably a neutral body like ONC rather than a self-interested vendor. It’s more than time.

EMR Data Often “Inaccurate” Or “Missing”, Study Says

Posted on September 17, 2012 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.

EMR adoption continues to march forward, spurred not only by Meaningful Use requirements but also the need for doctors to access data remotely and the rise of cloud infrastructure to support such initiatives.  According to research firm IDC, 80 percent of healthcare organizations should adopt EMRs by 2016.  Pretty much what you might expect.

Hopefully, this will have a positive impact on clinical care. However, EMRs may be less useful than they should be for population health research, as data is often inaccurate or missing, according to a new report published in the Journal of  The Medical Informatics Association.

Researchers behind the report said that while data from EMRs can be useful, it’s prone to certain types of errors which undermine its value.  For example, EMR data accuracy varies depending on whether the patient was treated during the day or during the night, in part because patients at night are often sicker, according to Dr. George Hripcsak, a professor of biomedical informatics at Columbia, who recently spoke with eWeek magazine.

Another issue of concern is that patient symptoms are often poorly documented in EMRs before death. For example, patients with community-acquired pneumonia who enter the ED and die quickly don’t have symptoms entered into the EMR before they die. Later on, their medical records make it look as though a healthy patient died, the researchers note.

Dr. Hripcsak told the magazine that researchers in informatics, computer science, statistics, physics, mathematics, epidemiology and philosophy will need to work together to get an accurate read on EMR data and avoid biases. (Whew!)

Clearly, the kind of teamwork Dr. Hripcsak has in mind will take a great deal of resources. They’re on their way, it seems. For example, I’m betting that the new Johns Hopkins center for population health IT will serve as a model for the kind of interdisciplinary efforts he’s describing. But that’s just one effort. It will be interesting to see whether other universities follow in Johns Hopkins’ footsteps.