At Cleveland Clinic, the data is all about the patient

It's a pretty awesome time to be a healthcare technology reporter, professionally speaking. Personally? I see green every time I hear about the latest advance in patient-facing healthcare technology that I don't have.

I won't tell you what behemoth Boston health system my physician belongs to, but when David Levin, M.D., CMIO of the Cleveland Clinic Health System, told me all the things the organization's patient portal can do, I considered moving to Ohio.

Briefly, but still.

The Cleveland Clinic Health System has checked off a lot of the items on my list of five things I want my patient portal to do and my list of four (more) things I want my patient portal to do. That includes a newer addition: Access to doctor's notes (hospital notes to come, he says).

Levin will be part of a panel discussion I'm moderating Tuesday morning at the mHealth Summit in Washington, D.C., on mHealth's role in patient engagement. (It's not too late to register online and join us for breakfast--if you're on site, you can also sign up at the registration booth.)

I asked Levin to give me a sampling of the mHealth efforts at Cleveland Clinic, including the patient portal, and to tell me how it's improving patient engagement, quality of care and the bottom line.

"We have to acknowledge this is new and we're still learning," he says. "But initially it's been overwhelmingly positive."

FierceHealthIT: How are patients using and responding to the patient portal? How are they interacting with their own health data?

Levin: We're finding in the early going that people use the information responsibly. They use it as a starting point. We think it's important that you lead people to sources of trusted health information. I don't want you to do a blind internet search.

We're actually finding patients help us fill in gaps in the record and find errors in the record. And I know that makes some people queasy. But we think this is a boon for patient safety. The position I take is the error is already there. This is about all of us working together to correct it.

I can't think of a single example of a patient who's gotten angry or threatened legal action. They know we're human and mistakes happen, but we're finding that if we present this to them and give them an easy way to help us correct it that they're more than willing to do that and very understanding about it.

FHIT: How else can your patients contribute to their health record?

Levin: At the Cleveland Clinic, we have deep experience with patients adding their own information. Patient-reported outcomes will be one of the next big things.

Dropped handoffs is a terrible and widespread problem in healthcare. This is one way to deal with that. But it also enriches the data set. So it includes questions about how you're feeling physically and mentally and the ability for you to enter data from your glucometer, for example. These are data streams that are starting to emerge and they have enormous potential to enrich the data set and the actionable knowledge that comes from that.

We're starting to use it to drive the planning of care. We've done this for a while with our stroke patients. They report information about their functions but also signs of depression, for example. We've demonstrated that not only can we collect this and that it's accurate but we can change treatments based on it.

Our latest project is with patients who are having hip or knee replacements. We can predict what the result will be and what level of care they're going to require after the procedure. We used to collect it manually, and it was hit or miss if it made it into the record. But now this is something that patients complete before the visit with the doctor. They can go online and do it for the portal or when they show up to the office they can complete it on a tablet--it takes about five minutes. That information is hard-wired into the electronic medical record, and it drives clinical decision support. The doctor is presented with options based on the information the patient put in directly.  

FHIT: So how does all of this improve the patient experience?

Levin: My whole career has been about high-tech, high-touch. I'm a family doctor that's a geek. The problem is that too often, the technology gets in the way. That's an artifact of where we are in the journey. But ultimately we want these things to free up our caregivers to spend more time with patients, to really be with patients.

So, to me, this is the ultimate goal but also the challenge--to have technology receded into the background. That's not where we are now. But we're going to get there. I really believe that.  

Editor's Note: Check out our great line-up of panel speakers for tomorrow's event, including Steven Steinhubl, M.D., director of the Digital Medicine program at the Scripps Translational Science Institute. Hope to see you bright and early in the morning. 

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