April 20, 2014

Increasing Doctor–Patient Communications

Continued from yesterday's blog

I admit I don't have much faith in doctors and many patients being able to improve communications under the current circumstances and health care laws. Many patients have lost access to their doctors and have been placed by their insurers with new doctors. This not only make communications more difficult because both are starting over with new beginnings. Others that have retained their doctors are wondering if they have a good thing and why so many others have had to move doctors. A lot of nervousness currently exists and this affects communications.

Nancy Finn thinks technology will help in communications. While she may be seeing some improvements and changes, I have some reservations about what I am seeing in the lack of technology advances and refusal by doctors to accept technology, except what is useful in practice or will earn them money. Some doctors to satisfy the stage 2 “meaningful use” requirements are making use of patient portals on a very limited basis and most are not allowing corrections to records. Believe me, I have tried as I have found some serious errors in my medical record.

Nancy thinks that if patients and providers use tools such as the internet and mobile phones to track medical conditions, everyone can benefit. She also lists tools such as patient portals to engage in e-visits, and email to discuss non-emergency issues between visits.

After doing some research, Nancy may be on to something. This article, published on April 7 in the Star Tribune describes something I was not aware of until I read it. Doctor on Demand started about four months ago and is now in 40 states, with 1000 doctors on staff. A 15-minute video session costs $40. Minnesota Blue Cross and Blue Shield is behind this and telemedicine is being used for home visits and people going to a kiosk which has some instruments available to take vitals. Some even have an autoscope tool with a camera attached to look into ears.

This doc-in-the-box is quite satisfying for many patients. Other doctors are raising the issue of the quality of care, but patient satisfaction is running high. Even advocates for virtual exams say they work best for routine cases, but when it comes to complicated diagnosis and treatment, there is no substitute for an office visit. Even I am going to investigate what may be happening in my state of Iowa and whether this might be available here. I do doubt that Medicare is involved in this, as the only telemedicine they have become involved in to-date is when providers are on both ends.

Nancy Finn also covers wearable devices, phones and the internet to monitor chronic conditions. She lists mobile phones to text instant messaging and to deploy apps to track heart rate, blood pressure, blood glucose, weight, and fitness.

Rather that list the suggestions that Nancy has for patients and doctors, I suggest that you take time to read her blog. One item she did not mention in constructing a personal health record is to make use of Microsoft HealthVault. Read about this here and with any choice you make, please use a secure choice.

I will quote her last paragraph as it expressed my thoughts as well. “When all the parties in the health process understand the need for communication and work at providing the pathways to make it happen there will be less frustration and dissatisfaction, and the safer practice of medicine for all concerned.”

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