Websites To Tell Your Patients To Use

 

The most recent survey conducted by the PEWResearchCenter showed that 72% of adult Internet users have searched the Internet for a range of health information. And now with the Affordable Care Act (ACA) implementing such ideas as shared decision making and patient engagement, the numbers will most likely increase. In order to maintain healthy patient-doctor communication, a good rule of thumb is directing patients to accredited medical websites.

 

Mayo Clinic

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A nonprofit medical practice and research group based in Rochester, Minnesota, the Mayo Clinic medical group has been in existence for 150 years. It has been ranked in the U.S. News & World Report’s List of “Best Hospitals” for nearly 20 years, and was ranked in Times top 50 Best Websites of 2010. As the first and largest medical group practice in the world, the Mayo Clinic has over 3,300 physicians and medical professionals researching and providing information to the Mayo Clinic website. And in 2010 alone, the Mayo Clinic’s research program generated 2,384 new protocols, which ultimately lead to over 8,000 human research studies and nearly 5,000 research publications. A great resource for both medical professionals and patients, the Mayo Clinic website provides an easy-to-use symptom checker tool and First-Aid guide. With the Mayo Clinic website, both a patient and doctor can maintain healthy communication and stay on the same page.

 

MedlinePlus

medical websites medical technology health IT medlineplus

Another online resource for medical information to direct ones patients is MedlinePlus. MedlinePlus combines the information of the National Library of Medicine and the National Institute of Health to present in depth encyclopedic information on over 800 health topics in both English and Spanish. And in order to increase user comprehensibility and ensure access to a range of health literacy levels, MedlinePlus provides links to view its website in over 40 other languages, as well. Unlike competitor websites, MedlinePlus does not endorse other companies or products, and prides itself in its nonprofit status, as well as its ability to therefore provide both safe and up-to-date health information. Having been recognized by notable sources such as Forbes.com’s “How to get the Best Medical Advice Online,” Consumer Reports’ “Websites That Work,” as well as having scored an 84 on the American Customer Satisfaction Index of 2010, MedlinePlus is an online resource with both reliable and quality information that can help patients and doctors be on the same page when it comes to communication.

 

PatientsLikeMe

patients like me health IT medical technology medical websites

A resource unlike the previous two, PatientsLikeMe is an interactive website in which patients worldwide with similar diagnoses can connect to share their experience and track their health in real time. Resembling a social network for patients, PatientsLikeMe currently has over 250,000 members, communities that cover over 2,000 diseases, and an average of 10% of newly diagnosed ALS patients joining each month. And it’s not just for patients, either. With permission from their patients, physicians and healthcare professionals can sign in as guests on the site to view the records that their patients have been keeping. It’s a way to help monitor an illness and ultimately open communication between patients and doctors. In fact, recent surveys suggest that 60% of PatientsLikeMe users feel the website has made making decisions about treatments easier, while 63% report the website has helped in opening communication between users and their healthcare providers. Recognized by both Business 2.0 and CNN Money Magazine as one of the “15 companies that will change the world,” PatientsLikeMe is an online resource to which medical professionals can direct their patient while maintaining health communication.

 

According to the Census Bureau, in 2011 nearly 76% of American households reported having an in-home computer and 72% reported having in-home internet access. Such numbers matched with the ACA’s push for patients to become more involved in their own health care, means that more and more patients are showing up to medical appointments already having done research. That’s why it is more important now than ever before to ensure that you are directing your patients towards reliable and useful resources that will also help to maintain healthy patient-doctor communication.

What We Can Do To Improve Health Literacy, Part II.

As discussed in last weeks blog post, low health literacy rates are a serious problem within the U.S. Fortunately, with the goals set forth by the Affordable Care Act (ACA), improving health literacy rates and creating a standard which is accessible for those of all health literacy levels is becoming more of a priority. This week we will cover two more proactive steps which one can take to help improve health literacy rates.

Breaking Down Cultural Barriers with HRSA

According to the US Census Bureau, the US population in 2002 was about 287 million. And according to the White House Office of Management and Budget, a 2002 report estimated the number of patient encounters across language barriers each year at 66 million. When calculated, about 25% of the population experienced language barriers when visiting a medical professional in 2002, and that’s assuming every US citizen visited a medical professional at least once. A large reason for low literacy rates in America are cultural communication barriers. Fortunately, The Health Resources and Services Administration (HRSA) has developed an online tool to help break down cultural barriers and open up communication between medical professionals and patients. Effective Communication Tools for Healthcare Professionals (ECTHP) is a free online training tool presented by the HRSA and available for all medical professionals. ECTHP is a 5 module system, including education in the following areas:

 

  1. Health communication

  2. Health Literacy

  3. Cultural competency

  4. Limited English Proficiency

  5. Capstone Activity

 

With its 5 modules, the training service takes approximately 5 hours and can help providers in learning how to actively acknowledge cultural diversity, address low health literacy, and accommodate low English proficiency. It is a tool that has helped over 4,000 medical professionals and students in improving patient-doctor communication, and when utilized can help to improve overall health literacy.

 

Committing to the National Action Plan to Improve Health Literacy

Finally, in 2010 The U.S. Department of Health and Human Services developed the National Action Plan to Improve Health Literacy (NAPIHL). The plan was devised in order to engage organizations, professionals, policymakers, communities, individuals, and families in a linked, multi sector effort to improve health literacy. The plan itself lays out 7 goals that the U.S. Department of Health and Human Services believe are necessary to improve health literacy and promote communication between medical professionals and patients. The goals are as follows:

 

  1. Develop and disseminate health and safety information that is accurate, accessible and actionable.

  2. Promote changes in the health care delivery system that improve health information, communication, informed decision making, and access to health services.

  3. Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through university levels.

  4. Support and expand local efforts to provide adult education, English language instructions, and culturally and linguistically appropriate health information services in the community.

  5. Build partnerships, develop guidance, and change policies.

  6. Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy.

  7. Increase the dissemination and use of evidence-based health literacy practices and interventions. to communication, informed decision making, and access to health service.

 

Following these goals takes commitment on part of a medical practice. And while the NAPIHL is still in its preliminary stages, it is thought that each goal should work together as building blocks for a more health literate future.

Health literacy in America has been a problem for far too long. Assuredly, with the many goals laid out by the Affordable Care Act (ie: shared decision making, patient engagement, etc.) focusing our nation’s efforts on improving health literacy is now crucial. And with the different technological resources and government standards set in motion, a more health literate future finally seems possible. At Polar Green, we’re working towards designing innovative technology that promotes solutions to modern concerns such as health literacy. For more information on what we do at Polar Green and how you can get involved in developing more of a health literate future, visit us here: http://bit.ly/1mvdzkl

 

What We Can Do To Improve Health Literacy, Part I.

The Affordable Care Act (ACA) was signed into law in 2010. Section 3506 requires the implementation of shared decision making. Shared decision making is when a healthcare provider and patient use the healthcare provider’s expert knowledge and the patient’s right to be informed, to come to a conclusion in the healthiest next step of treatment. Ultimately, shared decision making has been proven to increase patient satisfaction. When attempting to qualify for a medical practices’ Hospital Value-based Purchasing (HVBP) incentive payment program, patient satisfaction accounts for 30%.

Defined by the National Library of Medicine, health literacy is, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” According to the U.S. Department of Health and Human Services, nearly 90% of American adults have difficulty using and understanding the health information that is routinely made available at healthcare facilities. Low health literacy rates are a significant problem in the United States. With low health literacy, shared decision making as well as qualifying for the HVBP incentive payments becomes a struggle. Fortunately, there are a few proactive steps being taken to improve health literacy and overall communication of medical knowledge to patients.

Websites and Medical Apps that Integrate “Health Literacy Online”

mHealth health literacy medical apps
“Runkeeper and health on iPhone” by Flickr user Jason Howie.

According to a survey conducted by the PEW Internet and American Life Project, 80% of internet users in 2006 had searched for health information online. In 2014, more medical practices and health professionals are now using the Internet to deliver health information than ever before. In order to ensure that this health information is accessible to those with limited literacy and Web experience, the Department of Health and Human Services has developed a guideline for Web developers in order to promote the creation of more accessible health websites and apps. This guideline is Health Literacy Online.

Health Literacy Online was originally created as a guide for building websites, though in recent years, it has been adapted for mobile health (mHealth) apps as well. There are 6 key strategies laid out in Health Literacy Online for developing and building more accessible medical websites that can easily communicate medical information to patients. The strategies are as follows:

  1. Learn About Your Users.

  2. Write Actionable Content.

  3. Display Content Clearly.

  4. Organize And Simplify.

  5. Engage Users.

  6. Evaluate And Revise Your Site.

Many companies have used these strategies in developing and building mHealth apps and websites. In 2012, healthfinder.gov launched a contest in which they would award a cash prize to whomever created an easy-to-use mHealth app that used healthfinder’s content. The result was Lyfechannel’s myfamily app, an mHealth app that allows for users to easily build personal or family healthcare plans aligned with the priorities of the ACA and healfinder.gov content. In developing such an app, Lyfechannel integrated the 6 strategies outlined in Health Literacy Online to create something accessible to all health literacy levels. Using technology, such as myfamily, that has been made in accordance to the Department of Health and Human Service’s guide to developing more accessible medical websites is one way to promote health literacy and communicate medical knowledge within America.

Health Literacy Online is both informative and reliable, yet it is just one of many proactive strategies for improving health literacy within America. In next week’s blog post, we will discuss two other tools that can be utilized in improving health literacy within America. At Polar Green, we design innovative technological solutions to help solve modern day issues such as health literacy. To find out more about what we’re doing at Polar Green, visit us here: http://bit.ly/1mvdzkl

 

The Benefits of a Patient Portal for a Medical Practice

 Since early 2010, the Affordable Care Act (ACA) has been calling for a revision and restructuring of many aspects of the American health system. One such aspect that the ACA has been aiming to restructure is how medical practices have been recording and monitoring health data. Before the ACA, the medical industry was one of the few industries that was still relying on an outdated system of paper records. Since October 1st, 2012, however, in order to qualify for the Centers for Medicare & Medicaid Services (CMS) incentive payment program, a medical practice must now be up-to-date and exemplifying meaningful use of Electronic Health Records (EHR). One such way to demonstrate meaningful use of EHR is with a patient portal.

A patient portal is a secure online website that a medical practice can implement in order to conveniently give its patients 24-hour access to personal health information. With a patient portal, patients can use a username and password to login and view their own medical information at any time so long as there is an Internet connection. Some examples of information that can be obtained from a secure patient portal are:

  • Recent doctor visits
  • Prescribed medications
  • Discharge summaries
  • Allergies

Many patient portals even allow for secure private messaging between patients and healthcare providers. While patient portal implementation will ultimately improve the communication of information between patients and doctors, there are also many benefits patient portal utilization can provide for a medical practice.

A patient portal will help improve a medical practices effectiveness of care as shown by HEDIS scores. Health Care Effectiveness Data and Information Set (HEDIS) is a widely used process within the medical industry to measure clinical performance. This performance measurement is one component of the National Committee of Quality Assurance (NCQA) accreditation process, meaning a higher HEDIS score, the closer a medical practice becomes to the NCQA’s highest accreditation tier of “Excellent”.

 

A study conducted by Kaiser Permanente, focusing on over 35,000 Kaiser patients in Southern California with hypertension, diabetes, or both, showed a direct correlation between patients using a secure patient portal e-mail messaging system and a rise in more effective care as measured by HEDIS scores (California Healthcare Foundation). The study itself focused on patients with these two chronic conditions because of their high frequency of occurrence and cost of care. For the practices implementing a patient portal, the proportion of patients whose HEDIS measurements improved in all measures ranged from 4% to 11%. With a secure patient portal messaging system, these chronic condition patients with high cost of care began to feel as if the quality and effectiveness of care was improving. And while the study did not focus on specifically which components of HEDIS were improved, the researchers who conducted the study suggest the three major facets were continuity of care, doctor-patient connectedness and self-management support.

A patient portal will increase a practice’s productivity. With the information and accessibility provided from a patient portal, ideally patients will become more active, taking a larger role in managing his or her own healthcare needs such as appointment scheduling, paying bills, etc. In return, this will decrease the volume of administrative phone calls and messages a practice receives.

In fact, in 2005, a study conducted by Eric M. Leiderman, MD, MPH, measured the total volume of a clinic’s incoming telephone calls while using a patient portal, compared to a few years earlier when the same clinic was not using a patient portal (US National Library of Medicine National Institutes of Health). The intervention group averaged 18.2% less telephone call volume than that of the control group. Because of this, the intervention group was able to average about 11% more visits per day and about 10% more Relative Value Units per day than the control group (California Healthcare Foundation).

A patient portal can save a practice money. Patient portals often come with many different functions including private messaging, scheduling, online billing, and more. With such functions handled electronically, a practice can save on both day-to-day expenses, as well as labor costs. In a March 2010 Health Data Management Magazine article, Elizabeth Gardner reported patient portals having saved practices $0.63 every time a practice does not have to mail lab results, $7.00 every time an appointment was scheduled online, and $17.00 every time a billing inquiry was handled online (Health Data Management Magazine). Furthermore, a similar study presented at the 2010 Northwest Medical Informatics Symposium reported that a secure messaging feature of a patient portal could save a practice $0.62 per appointment reminder, $1.75 for every phone call to a patient, and $2.69 for each lab test result delivery (California Healthcare Foundation).

If attempting to qualify for the CMS incentive payment program, it’s necessary for a practice to show meaningful use of electronic health records. Adopting a patient portal will not only help adhere to the incentive payment requirements, but also benefit a practice in many other ways. At Polar Green LLC, we’ve designed a prototype, the Informacio Workstation, that will help support meaningful use of electronic health records, as well as promote other sanctions of the ACA including, but not limited to, shared-decision making and increased patient engagement. To learn more about our mission and what we do at Polar Green, email us at vpaglione@polargreenllc.com.

Specialist Consults Via Video – The Next Best Thing to Being There

Does anyone remember not needing an appointment to visit the doctor? It’s hard to believe that as recently as the 1950s and 60s, going to the doctor appointment-less was not only permissible, it was the standard. Today, we all too often make appointments to visit the doctor, only to spend a significant amount of time in a waiting room and a relatively insignificant amount of time in actual doctor-patient consultation.

A primary care physician’s central goal is the delivery of coordinated and comprehensive care for their patient, and this requires a broad spectrum of medical knowledge, effective use of the local health care system, and attention to both the “big picture” and the details of a patient’s life and health. However, specialist physicians serve an increasingly pivotal role in modern medical treatment.

The ability to consult with a specialist is not only of increasing importance to the patient, but also the primary care physician. For the patient, interactions with a medical specialist will help them understand the specific illness or disease they have contracted, and will position them to make more informed decisions regarding the course of treatment they will undergo. For the primary care physician, the frequent interaction with medical specialists provide a form of continuing education that serves to broaden their understanding and knowledge of their patients’ illnesses and diseases. It’s a clear win-win, provided that all of the participants are involved.

With the numbers of medical specialists in many high risk fields like high-risk pregnancy, behavioral health and neurology in short supply in many metropolitan regions, it is of paramount importance that we find ways to leverage these scarce specialist resources across the widest number of patient cases possible. Traditionally, specialist consultations involved either a patient and a specialist, or a primary care physician and a specialist. Through modern telecommunications, it’s now possible for the patient, the primary care physician, and the specialist to engage simultaneously to discuss a patient’s illness or condition and possible treatment options.

And of course, it’s not just about the people – it’s also about the data. Aggressive routing and storage technologies can permit the availability of medical imagery (MRI, PET, CAT scans) from remote locations. Real-time streaming from specially configured medical devices can permit real time interactive clinical consultation.

Large hospital chains are investing millions to provide remote medical consultation services across their network of hospitals, care centers, and doctor offices with the hope of providing access to the few specialists they have for certain difficult medical conditions. Primary care provider networks are even taking it to the next level by providing patient follow-up consultations via secured Internet platforms that allow the patient to consult with their primary care provider from the comfort of their home or office.

Physicians have been traditionally trained to first diagnose, and then prescribe treatment – the two central activities in the delivery of health care. While there are steady achievements in the areas of researching and understanding illness or disease, inventing new medical devices, or devising new prescription protocols to treat illnesses, analyzing physician time as a resource has received surprisingly little attention. However, the amount and quality of the interaction between patient and physician has been shown to have statistically relevant impacts on more than patient perceptions of quality, but also measurable improvements in both health outcomes and patient loyalty.

Improving patient engagement in the health care decision process, combined with the effort to link monetary incentives to post-care outcomes may sharpen the attention for the physician to not only improve the amount and quality of communication with their patients. Primary care physicians should also make use of the technology at their disposal to involve available specialists in their efforts to diagnose conditions accurately and early and prescribe the correct courses of treatment for their patients.

 

The Benefits of Cloud-Based Electronic Health Records

With the Medicare and Medicaid Electronic Health Records Incentive Program now in full effect, many medical professionals nationwide are switching to electronic health records (EHR). And while such incentives may make switching to EHR very compelling, there are still EHR implementation decisions that must be made. One of the very earliest decisions to be made is to choose how you your medical practice will deploy an EHR solution – traditional client-server fashion, or in the cloud.

Reputable cloud based solutions come built-in with many benefits, such as redundant data and application servers, as well as automated backup and recovery mechanisms.  Access to the application for most users is provisioned through a web browser which means that there is no configuration of client software on user desktops.  Therefore, all that is generally required for using a cloud based system is a computer and a reliable and trusted Internet connection. However, in a client-server system setup, the servers providing the database and application functionality are, to a significant extent, the responsibility of the client.   Traditional on-premise client-server systems require a medical practice to have the correct server hardware and software installed to support the given EHR solution, and thus the office staff must be augmented with competent and trained IT personnel.   Alternative deployment scenarios for EHR client-server implementation include off-site hosting and application service providers (ASP), but there is still a significant technical cost of ownership on the medical practice.  While client-server systems have generally been the status-quo for enterprise technology for the past few decades, in recent years more and more practices are switching to cloud-based systems for the following reasons:

 

1. Advancing Technology. The pace at which technology is advancing is astounding. Investing in a client-server infrastructure for your medical informatics can expose you to some risk of your investment becoming obsolete in a year or two. Cloud based providers are constantly upgrading their technology infrastructure in a rotating fashion, and the costs of maintaining and upgrading this infrastructure are spread across all of the clients that use the cloud based infrastructure.

2. Fewer Points of Failure. When dealing with a client-server system, you risk encountering technical problems and potential loss of data or application access at each level of the client-server architecture.  Database corruption, application server faults, and client code incompatibilities could all lead to potential downtime with your EHR system.  Cloud based systems take care of much of the “plumbing” with an enterprise system architecture – including provisioning of redundant database and application servers.  With most cloud based end user application functionality provided through a web browser, there is for all intents and purposes a “zero-configuration” environment for provisioning the application within the office to users.

3. Increased Flexibility. A client-server system uses a predetermined amount of data storage on a database server to store its data, and an application server has a limited amount of memory for handling end user sessions and application logic.  By design, cloud based systems utilize server farms, and are scalable so your application or database server needs can grow without any concern for outgrowing the physical limitations of any one server in the farm.

4. Saves Money. When considering a client-server EHR system, paying for the high priced and necessary hardware and software licenses is just the tip of the iceberg. In fact, with a client-server system it’s common to find oneself paying for installation fees, licensing fees, maintenance fees, update fees and much more. With a cloud-based system, however, there is no hardware or software installation involved, just a simple and steady monthly payment. Ultimately, this makes your overall EHR investment a regular and predictable operating expense.

5. Data Protection and HIPAA. A significant consideration for any medical practice implementing an EHR solution is the degree to which a system affords protection of confidential patient data and restricts access to the application and patient data.  Cloud-based systems are designed and built with secure data and access management in mind, and use industrial grade encryption to protect stored data and data in transmission.  They also incorporate advanced authentication and authorization schemes to ensure that only properly authorized users are able to access the system and relevant patient data.  Thus, using a reputable cloud-based EHR system that complies with the Health Insurance Portability and Accountability Act (HIPAA) can be considered secure, and the burden of ensuring HIPAA compliance falls, in large part, to the cloud based solution provider.  With a client-server system, a medical practice must protect the system at the network, server, and application level in order to reduce the risk of hacking or unauthorized access to confidential data. Moreover, as the custodian of the client-server EHR system, the medical practice assumes the burden of ensuring that the system is HIPAA compliant.

6. Increased Patient Engagement. With a cloud-based system, a patient’s health and medical records can be easily accessed at a moment’s notice. And with today’s new medical technology, such as the Informacio Workstation, accessing a patient’s medical information and then verbally and visually sharing it with the patient is easier than ever before. Together, a cloud-based system with the Informacio Workstation is a way to increase communication in a way that is both engaging and simple to understand.

With the Medicare and Medicaid EHR Incentive Program, many medical practices are making the switch to electronic health records. And while both a cloud-based system and client-server system are two viable options, the benefits of a cloud-based electronic health records system seem to span far beyond just incentive payments.