In a perfect world, collaborative care records would be used by all of the people, all of the time, says NoMoreClipboard President Jeff Donnell. "I think we have to get away from 'there's the patient record, there's the electronic health record that the provider has, and the two are separate,'" Donnell said at last week's Consumer Health IT Summit in Washington, D.C. "More and more, we need to figure out ‘How do we make it more of a collaborative record?' and ‘How do we make it easier for data to flow back and forth between clinicians and consumers?' so they're all seeing the information and they're able to have better conversations."
Donnell talked with FierceEMR about what's going on in Washington regarding health IT, trust between patients, providers and the government, and his company's latest venture, cc:Me. He also summoned alter ego Brantley Whittington of Extormity to discuss the faux company's most recent endeavor.
FEMR: What are your takeaways from these increased efforts by the government to bring heath IT into the limelight?
JD: What's so exciting about what we're hearing is this emphasis on the patient. It is all about that individual and how do we put them at the center. But then, how do we use technology to make this all easier. It doesn't have to be that hard.
As always, none of this stuff is really a technical challenge. It's all about education; it's all about getting people more comfortable--a new way of doing things. As we tell people, look, there are 245 million Americans on the Internet. Why in the world would you make one of them fill out a clipboard? These people are banking; they're shopping; they're booking their travel online, and they show up at the doctor's office and we say, "Here, fill this thing out."
Instead, we need to use basic technology to get data in the hands of patients and to make it something that they can work with and use.
FEMR: Why do you think it's taken so long for these kinds of efforts to finally get more attention?
JD: It's interesting. I've spent the last five years evangelizing on consumer engagement and being told "no, the time isn't right. Maybe someday." It's as though someone flipped a switch in the last six to nine months, and all of a sudden everybody gets it.
I think that part of it is that we have patients that are using the Internet for everything else, and they're saying, "Look, you guys may be behind the times, but we're going to drag you, even if we have to drag you kicking and screaming into the future." I think part of it, too, is that consumers-patients are now being forced to pay more and more for their own healthcare. It's very rare that you go to a job, and they say, "Oh, don't worry; we'll pay for all your health insurance." You get the package that they give you, and usually you're going to pay for at least half of it. And that amount goes up every year.
And then you add in the fact that there are all of these incentives for doctors and hospitals to go electronic. You kind of smash all of that together; you've got this wonderful confluence of things that are really driving patient engagement.
FEMR: How important is trust between patients, providers and the government?
JD: I think it's critical. The patients want to know that their privacy, their security, is being taken care of and it's being well-managed, and that's not something you can take for granted. It's not just a checkbox, and that's why this model patient-privacy notice that they're putting out there is so valuable. It's going to level the playing field, very much like a nutrition statement on the back of anything that you pick up at a grocery store.
FEMR: What can you tell us about your latest project?
JD: There's been a lot of talk, and people have written about that fact that some day, wouldn't it be great if every American had their own health web address or their own health email address? And they could give that to their doctor and say, "Send me my information?"
We looked at that and said, "That is a great idea, but that isn't something that we have to wait 10 years for. In fact, we can do that today." We started working in cc:Me to answer that sort of visionary call, but also we recognized another great benefit of Meaningful Use. In order for an electronic health record to get certified, it has to be able to generate a CCD (continuity of care document).
We put two and two together because we knew that if we could get our hands on the CCDs, we could not only bring it into NoMoreClipboard, but we can take the discrete data, populate your personal health record, and it's all filled out, so the patient doesn't have to go in and start from scratch.
FEMR: What's the latest with Extormity? Anything on the horizon?
JD: Great question! I'll refer you to Brantley Whittington for that answer.
BW: CCD, CCR and other acronyms beginning with CC are emerging as the de facto standards for achieving simplified movement of health information. To that end, we'll soon be rolling out our CCR/CCD information sharing module.
If a patient requests information from an Extormity provider, they will be given the option of CCR or CCD. We all know that patients who came of age in the 1960s and '70s prefer CCR, and we provide them with a CD containing their greatest hits, including Bad Moon Rising, Proud Mary, etc. Our EHR downloads such tunes and burns them on a CCD while the patient waits.
Patients opting for the CCD format, by and large, are Catholic parents of children who attend public schools. The CCD module generates a catechism document that satisfies both Meaningful Use patient education and church doctrinal teaching requirements.
Editor's note: This interview has been edited and condensed for clarity.