Take Two Apps and Call Me in the Morning
An Ever Increasing Array of Gadgets and Widgets Is Changing the Doctor-Patient Relationship
Instant Access, Constant Communication
Some changes in health care seem to carry obvious benefits, at least on the surface. For example, EHRs provide instant access to patient information that is available 24 hours a day, seven days a week. Physicians can more easily gain access to a comprehensive medical history for a patient than ever before -- sometimes even if they've never seen that patient in that clinic. But even this benefit holds challenges. Dr. Keith Henry, Professor of Medicine at the University of Minnesota, says that the amount of time he spends in the medical records system actually reduces his face-to-face time with patients. "My patient interactions are depersonalized because I have to pay attention to the computer," Henry explained. "People already complain that they don't get enough time with their doctors." As director of HIV research at Hennepin County Medical Center in Minneapolis, Dr. Henry has been involved in caring for HIV patients since the early 1980s. He has seen the impact of technological changes in the health care industry firsthand and speaks from experience about both the benefits and the costs of electronic systems.
Another benefit of technological advances in health care comes from the ability to communicate across distances with greater ease. Most patients no longer rely on a single physician system, often seeing multiple providers at different clinics. To provide integrated health care, these providers need to stay in touch, which eHealth makes more possible than ever before. Providers can use secure data transfer software to ask for a review of patient information by a colleague. They can touch base by email or receive a health summary before a patient's appointment. Keeping these lines of communication open and accessible provides great benefits for patients, because their providers can stay up to date with their treatment progress, even outside of their own practice. Time is finite, however, and constant connection brings its own issues. In Dr. Henry's practice, he's finding that he spends more and more time using electronic communication, and less time talking with colleagues as well as patients. "You're always basically connected," he explained. "It's very hard to get away for a break or free time."
The changes brought by technology are permanent; there won't be any backwards movement without a serious change in circumstances. The transition from paper to electronic records isn't temporary. EHRs are here to stay. The Federal government has mandated that EHRs must be available for "meaningful use" by 2014. Patients should receive better care since EHRs can be accessed by multiple clinics and providers within any given system. Patients can also become more informed by having access to their medical records online. Unfortunately, there's no mandate that requires communication across different systems, and this can reduce how effective they are for a health care provider.
In Minneapolis and St. Paul, there's been a movement to integrate the medical systems across most of the hospitals there. "When patients come see me, I can more often than not get into their records elsewhere. I can see their labs or x-rays and see what needs to be done," said Henry. But even the benefit of quick online communication can eat up time that could be spent with patients instead. It comes down to finding the balance between face time and time online for physicians in the clinic and at home after hours. This balance is challenged by many of the rules and regulations in the health care industry.
Aways Room to Grow
The patient-doctor relationship is continuously evolving. How does technology affect the pace of that evolution? The relationship will be enhanced, hindered, or unaffected, depending on region, resources, and the way that technology is being used. Different people face different challenges and only through strategic application can technology be useful for any individual. With mindful development and careful research, technical advances can be powerful resources that have the potential to take us further into useful health care for both patient and provider.
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This article was provided by Test Positive Aware Network. It is a part of the publication Positively Aware. Visit TPAN's website to find out more about their activities, publications and services.
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