There's an old proverb that says if a man is taught to fish, he'll never go hungry.
To that end, listening back to testimony delivered by Intel's Eric Dishman and others last week at a Senate committee hearing on improving consumer access to electronic health records, it's clear that the Office of the National Coordinator's decision to focus more on the patient in its updated federal health IT strategy is the right one.
Dishman, a cancer survivor, discussed the struggle to have his voice heard among all of his doctors, despite technological advancements that should make such a process easier.
"Moving to the paradigm of coordinated care teams where patients are part of it--this is hard," Dishman said. "I had to actually fight to be a bona fide member of my care team."
He also talked about the process as a change in culture.
"We're undoing 150 years of 'the doctor has the information as a lone practitioner,'" Dishman said. "That requires re-education of the patient to have more responsibility, and re-education of the clinicians."
That's what makes the shift by ONC so important. ONC saying that its efforts will be more patient-centric than program-centric is more than just rhetoric; it seems to be an acknowledgment that, no matter how many new tools are developed, both providers and patients together must figure out the most appropriate manner in which to leverage them.
What's more, it's not as if ONC is abandoning the necessary work of standards development and building up the nation's health IT infrastructure; rather, it's ensuring that patients feel not just empowered to be members of their own care teams, but the need to be actively engaged in such efforts.
"The general shift that this points to is that one, as an administration, we are putting the person at the center of their own health data, as opposed to the center of our health IT approach being electronic health records and healthcare systems," National Coordinator for Health IT Karen DeSalvo said of the plan.
Raj Ratwani, scientific director for MedStar Health's National Center for Human Factors in Healthcare, who testified alongside Dishman, said electronic health record systems should be designed more with both doctors and their patients in mind.
"We need to design these systems so they're intuitive for clinicians to use, intuitive for patients to be able to adjust their information, and importantly, it's not just about the interaction pieces," he said. "It's also about how the information is represented."
Important pilots of work headed in that direction via the OpenNotes program have already shown successful results. Research published in August in The Joint Commission Journal on Quality and Patient Safety determined that through five years, OpenNotes increased safety, care quality and patient engagement. To that last point, in particular, patients reported feeling more in control of their health. And doctors noticed little or no impact on their workflow.
As Dishman said, the process won't be easy. But patients and providers will be better off in the long run. - Dan (@Dan_Bowman and @FierceHealthIT)