Hospital CMIO: Providers are 'scared' of innovation

With patient engagement tools like Fitbit and personal health records growing more and more abundant, a primary goal of providers in today's society must be to avoid obstructing the flow of information from patients and their tools to medical professionals, according to Ryan Bosch, chief medical information officer at Falls Church, Va.-based Inova Health System.

Bosch, speaking on a patient engagement panel at the Office of the National Coordinator for Health IT's annual meeting in Washington, D.C., last week, called interoperability paramount to those efforts, but also called the health industry, as a whole, scared to innovate.

"No longer do people want to use technology as a synonym for a fax," Bosch said. "But healthcare is very scared; we're scared to develop on our own. If you look at any other industry, they have a huge research and development technology arm. Healthcare wants to manage technology like you'd manage a couple of horses in the stable. We'll care for them and feed them, but we wouldn't' dare do anything else on our own. We've got to change our mindset."

Part of changing that mindset, according to Donna Cryer--a D.C.-based patient advocate who suffers from autoimmune conditions--is thinking of patient care as more of a partnership. While Cryer said that she thinks of herself as both an engaged and an activated patient, she stressed that not all patients are willing or ready to take that same kind of initiative.

"A consumer might be someone who doesn't have very frequent interactions with the healthcare system," Cryer said. "I think it's important to design education and engagement strategies and expectations for patients trying prevent hospital visits," in addition to patients like herself who need constant treatment.

"Patient engagement takes at least two parties, and unless there's that partnership, there really won't be any engagement."

Lygeia Ricciardi, director of the office of consumer eHealth at ONC, agreed, saying that patients need to feel comfortable asking questions and sometimes disagreeing with their providers. Technology, she added, helps to bridge a gap.

"If we can get information flowing to people, we want them to have a variety of tools and apps to work with," Ricciardi said. "Trust is the bedrock of the patient-provider relationship. Patients must feel comfortable that their information is where it should be." 

A study recently published in the Journal of Participatory Medicine outlined several tips for physicians to engage patients through the use of digital technology, including:

  • Working with patients to achieve a common understanding of the types of information patients would be sharing, how the sharing would take place and which members of the clinical team would be reviewing the information and how often
  • Designating and training a member of the clinical care team to monitor incoming data and triage as necessary
  • Putting a medical emergency protocol in place
  • Using appropriate judgment in deciding when patient-generated electronic health information would be included in the physician's legal medical record

The study focused on efforts within Project HealthDesign, a research program funded by Robert Wood Johnson Foundation.

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