December 9th, 2011 by Elaine Schattner, M.D. in Opinion, True Stories
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Over the weekend I developed another bout of diverticulitis. Did the usual: fluids, antibiotics, rest, avoided going to the ER, cancelled travel plans.
One of my doctors asked a very simple question: is this happening more frequently? The answer, we both knew, was yes. But I don’t have a Personal Health Record (PHR) that in principle, through a few clicks, would give a time-frame graph of the bouts and severity of the episodes over the past several years.
The last time this happened, and the time before that, I thought I’d finally start a PHR. Like most compulsive patients, I keep records about my health. In the folder in my closet in a cheap old-fashioned filing box, the kind with a handled top that flips open, I’ve got an EKG from 15 years ago, an Read more »
*This blog post was originally published at Medical Lessons*
December 4th, 2011 by DavedeBronkart in News, Research
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Wow. Todd Park, Chief Technical Officer at HHS, ought to be jumping out of his skin with joy at this one.
This time, House, M.D. fans, it was lupus. The article “Evidence-Based Medicine in the EMR Era” published in the Nov. 10 issue of the New England Journal of Medicine might have read like a House television script, but it was a real-life glimpse of what the most optimistic health IT advocates are hoping will become commonplace in U.S. health care: Mining EHR data to arrive at treatment decisions.
In a Health IT Exchange piece (on TechTarget) EHR data spurs real-time evidence-based medicine, Don Fluckinger summarizes (and dramatizes, accurately) this early specimen of care being transformed – beyond the literature – by looking at past records. Faced with a 13 year old lupus patient with a complex problem (see article for details)…
In four hours, they did a retrospective study of similar patients in the hospital’s data warehouse…, and decided to move ahead with the treatment based on the previous results of 98 [similar patients] … The authors said they will never know if they made the “correct” decision, but they did know that — in absence of randomized trial research to support their decision — they acted on the evidence of the best data available, coupled with their experience.
“Our case is but one example of a situation in which the existing literature is insufficient to guide the clinical care of a patient,” the authors wrote. …
What are we waiting for, people?? Imagine if Read more »
*This blog post was originally published at e-Patients.net*
September 15th, 2011 by Dinah Miller, M.D. in Opinion
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Please see my post on Clinical Psychiatry News and yesterday’s post What’s in a Note? along with the reader comments.
One reader asked why it’s weird to want to see your shrink’s notes and why shrinks refuse to show them on the grounds that they may distress the patients. Another reader asked why doctors write “patient denies” as though they don’t believe the patient. These are both great questions worthy of their own post.
Why don’t psychiatrists like to show patients their notes? Are they really going to “harm” the patient? There are a few reasons why a psychiatrist may not want to show a patient her notes. Here is my list of thoughts as bullet points. Please feel free to add to it. Read more »
*This blog post was originally published at Shrink Rap*
September 11th, 2011 by DavedeBronkart in News
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Big news from Down Under: the Sydney Morning Herald reports that a group of fifty consumer health advocates has unanimously backed an “opt-out” process for enrollment in electronic health records, reversing their previous position.
The issue is whether by default all patients have an EHR. “Opt-out” means you’re in by default – your records will be stored electronically – and you can opt out if you want. “Opt-in” means you do not have an EHR unless you specifically ask for one.
The group, the Consumer Health Forum, cites evidence from the neighboring country of New Zealand, in which Read more »
*This blog post was originally published at e-Patients.net*
May 29th, 2011 by DavedeBronkart in Research
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The Society for Participatory Medicine was well represented last week at the 14th ICSI/IHI Colloquium. (ICSI is the Institute for Clinical Systems Improvement, a small midwestern think tank that’s way too poorly known.) SPM members who presented:
- Jane Sarasohn-Kahn of Health Populi gave the keynote for Day 2
- Jessie Gruman, four time cancer patient and founding co-editor of our journal, gave an important breakout session, about which I’ll be writing soon. (Jessie is founder and president of the excellent Center For Advancing Health.)
- Brian Ahier presented on the status of health IT, as Meaningful Use rolls out. (“You can’t measure the improvements that you gotta measure, unless you have computers keeping track of it.”)
- I gave a half-day pre-conference workshop titled “Participatory Health: Reshaping Patient Care.” I’m told the workshop had 40-50% higher registration than usual: interest in participatory medicine is strong.
An unexpected bonus was that right outside the workshop door, a poster presentation addressed some questions people often ask about patient participation and online health records:
- Will patients with problems actually use a PHR (personal health record)? (Many observers say PHRs are a non-starter, a pointless exercise.) Read more »
*This blog post was originally published at e-Patients.net*
