The Wicked Health Care Webs We Weave

October 26, 2010

Never shy retiring wallflowers, the Health Care Social Media (HCSM) group on Twitter pitched a flurry of ideas on what ideal features they would wish to see on their doctors’ Web sites during their October 24th, 2010 chat.  Given that not many doctors even have Web portals, the exercise itself is somewhat ambitious. Nevertheless, the enthusiasm and the breadth of imagination provided by this crowdsourcing exercise makes clear that the demand is present and that there is much that health care providers can do improve the current model.

Here is a synopsis of what the HCSM tweeting participants suggested:

  • Trustworthiness — @foxepratice and @marksphone urged that a doctor’s site be, “a trusted resource for knowledge and community, in the broadest sense. In one example, @pfanderson suggested that links to government sites related to the physician’s specialty be provided.
  • Convenience — @RichmondDoc suggested that a doctor’s site can be a place where patients can, “review/discuss labs, e-mail, and maybe schedule appts.” @DrJonathan went one step further: “I like when practice websites offer new patients to fill out all necessary forms online before their 1st appt.” That idea was roundly supported in the HCSM circle. The popularity of this idea was only exceeded by @ddiamond’s yearning for online scheduling ala the OpenTable model: “If a yoga studio can do it, why not an MD?”
  • Security — This attribute was echoed by nearly everyone in the HCSM chatroom, ensuring that HIPAA protection was provided on their physician’s Web site. Specifically, the group noted that a secure portal was a minimum requirement, bolstered by a clear notification of the doctor’s privacy policy.
  • Basic Information Provision — For some, simply providing hours of operation,  and contact information (including emergency contact details) was considered a good start.
  • Accessibility — This hallmark was interpreted in various ways as an essential quality of a doctor’s Web site, from being interactive and easy to navigate (as @thehealthmaven requested) to providing true accessibility to people with physical challenges (as @Healthpolicygrp noted).
  • Beneficial — @nickdawson suggested that, “it should do something or be of value for me and get out of the way of finding info.” Echoing this point, @MeriLizzie argued for information on rare conditions that affect dental health from dentists. @pfanderson commented that the site could also offer, “Tips to make yr visit more useful / tips on when to call the doc/when not.”
  • Outcome Reportability — @Marksphone urged that the doctor’s Web site gather patient entered data for better tracking and long-term outcome assessment.

@pfanderson boiled down these recommendations in pithy fashion. The ideal doctor’s site must indicate, ” How2FindMe; WhoIAm/WhatIDo; WhatIWantU2Know; People/Places/Info I Respect; MyCredentials/Memberships; Personal/Hobbies.”

These suggestions are not merely blue-sky chatter.  Many in the group stated in point-blank fashion that a physician unwilling to even create a Web site meant that the doctor was behind the times and not likely to meet their needs. To quote  @susangiurleo, “No website, I won’t be a patient. Lack of online presence makes me think they are out of touch.” As patients grow more empowered in their health care management, doctors are well advised to integrate this “wish list” of web-centric elements into their medical tool kit. Their success and viability may depend on it.
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Patient Portals: Socially Wired to Future Health Care

September 20, 2010

In Mark Ryan’s recent post, “How Social Media Can Enhance Medical Practice,” he suggested that the Patient-Centered Medical Home (PCMH) model would allow doctors to provide e-care (e.g. texts and email) because it enhances the communication between doctor and patient.  In a serendipitous coincidence, Gisela Nehring, Manager of Information Technology at the Cleveland Clinic, recently composed an insightful blog on what her organization is doing in harnessing patient portals and how they are actually improving patient satisfaction, lowering costs and reducing physician workloads (Read it here:  Patient Portals). Many aspects of the Cleveland Clinic program are a wish list of services that would make any patient not in their system envious. As it is presently constructed, the Cleveland Clinic offers around-the-clock access online to health summaries (including procedures), test results (except for the most sensitive which are conveyed directly by the physician), medication lists, allergy lists, immunization lists, problem lists, prevention reminders and health trends (a feature that allows patients to graph their weight, blood pressure, pulse, respirations and lab results). On the horizon, the institution will offer remote monitoring, patient scheduling  and anesthesia risk analysis.

The idea of remote monitoring got all of us here at HCSM blog central brainstorming ideas we’d like to see Cleveland Clinic and all other health care providers consider.  We offer a short list of additional services that would work well within the patient portal framework:

  • Support Groups: Linking patients together as an opt-in function would allow new opportunities for sharing and support between patients, founded on the trusted relationship with the health organization.  One example could be for patients to pair up as buddies who are seeking mutual goals (e.g. weight loss or improved dietary adherence). This notion is supported by a recent study from UCSD researchers on the effect social networks have on obesity. Other conditions also appear to be affected (Read here).
  • Patient Co-mentoring:  Patients who have triumphed over their diseases (e.g. cancer survivors) are in a unique position to offer support and insight on coping with disease to the newly diagnosed. Expanding access to this portal to veteran patients to reach out to new patients would add a great deal of value to patients who understand “where they come from.”
  • Group Visits: If the portal model could allow for live hosting of group visits, then general information in a larger group setting could be supported. Such visits would be led by a doctor, and perhaps even recorded for later viewing. Broad disease topics could be entertained in these forums. Individual visits would not be held in this setting.
  • Public Conversations: If there were a way to hold public forums on prevention or current health issues as webinars through such portals, we see new bonds that could be established between health care providers and their communities.
  • External Discussion Groups, Led by Physicians: Building off the Group Visit idea, physicians could lead discussions among related patient-oriented audiences (e.g. caregivers, children of patients, etc.) to explore how improved care can envelop these social networks.
  • Physician /Hospital Alliances: If an organization, like the Cleveland Clinic, opened its portal to neighboring physicians, such a relationship could mutually support the interests of both parties while advancing improved care for the patient.
  • Data Mining:  While the current model expressed by the Cleveland Clinic mentions the use of data to build trending graphs, we urge a greater use of data mining to perform needs assessment and gap analysis. These twin activities would help health care providers identify changing needs while improving treatment strategies.
  • Provider Knowledge Library:  We also believe there is untapped potential in opening access to the database among patients for broader health care learning, serving as a trusted “WebMD.” The source could be enhanced by other general health care information, vetted and validated by the health care provider’s medical librarian. The  medical library would provide reliable content and enhance a patient’s ability to critically evaluate medical information.

These are just our initial thoughts, so we invite you for your ideas on how to make patient portals more social to enhance health care delivery and outcomes.


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