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Delivering Quality Medicine in an Electronic World 

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Well-Informed Patients, Better Healthcare Just a Click Away
By David Levin, MD

Patients get the best care when they have access to information. The patient who understands their medical problems and what to do about them is far more likely to have good results. In other words, an educated patient is an empowered patient.

Most physicians get great satisfaction when they see patients who are actively engaged in their own healthcare plan. Studies have shown that a patients’ attitude about health is directly linked to well being. The “activated” patient is truly willing to make the necessary lifestyle/diet/medication changes to ensure the highest level of health possible.

Like many of you, I conduct my banking and shopping online. I use the internet to find various kinds of information – from medical research to the local movie listings. The internet pervades almost every facet of life for most of us and we continue to intertwine this technology into everyday life. The astounding popularity of social media sites such as Facebook and Twitter are evidence of that.

And then there is healthcare. Why is it still seen as “progressive” to use the internet and other related technology to deliver healthcare? We are long overdue to move aggressively in this direction. After all, healthcare lags far behind many other industries such as banking. A patient once asked me, “Dr. Levin, how come FedEx can tell me where my package is any time, any where in the world but you can’t tell me the results of my CAT scan from last week?” It’s a great question.

Fortunately, we are now beginning to see a much greater prevalence of electronic medical records locally. The Federal government is now offering stimulus money for Electronic Medical Record (EMR) implementation. This will likely drive even more providers to adopt EMRs in a wide variety of healthcare settings – from hospitals and long term care to physician offices and home based services.

The greatest advantages of electronic health records can be achieved when all these separate entities share information in order to paint a complete picture of any given patient’s health. In other words, the information should follow the patient wherever they go. There is one “chart” and it is always available regardless of location – Emergency Department, hospital, office or testing center. At Sentara, we have already begun to see evidence of these benefits at work. With the ability to capture data and make resulting changes to care, the implications of this program go far beyond automating healthcare processes.

Electronic medical records allow for the capture of data, in real time, so that we can more effectively measure and adopt care practices that will improve quality for patients. In addition, we can be more responsible stewards of healthcare resources by eliminating expensive duplication of tests. I am a firm believer that “Quality Pays” - better quality care can also mean lower healthcare costs.

An example of this impact was seen during the H1N1 flu outbreak. Physician leadership was able to quickly review the recommendations of national experts and put in place the most up-to-date clinical practice guidelines for H1N1 screening and treatment. These guidelines were instantly communicated across the entire health network to physicians caring for patients in hospitals, emergency rooms and offices. Reports were created to track the volume of patients to help effectively manage critical supplies of vaccines and medications and to deploy staff to the busiest areas. As a result, providers were prepared to handle the influx of patients and had confidence that they were following the latest and best recommendations. Total time from initial concept to full implementation: two weeks. This would have been impossible in the previous world of paper medical records.

Perhaps the most exciting part of introducing electronic medical records is the ability to include and empower patients in new ways. Internet-based patient “portals,” such as Sentara MyChart, allow patients secure access to their own medical record. There are many practical uses such as scheduling an appointment or requesting a refill. This patient portal also offers access to test results and the ability to ask a basic question of the physician or nurse directly without having to play phone tag over days or weeks. The portal also provides trusted, reliable information for patients about their test results, medications, and medical condition. Again, the educated and empowered patient is more likely to do well.

When we are all working in concert toward the end goal of improved health for the patient, then we have achieved the best medicine.

David Levin, M.D., is vice president of Medical Informatics for Sentara Healthcare. His current focus includes information systems, knowledge management and clinical transformation. Dr. Levin holds degrees in Biology and Medicine from Brown University. He completed his residency in Family & Community Medicine at Brown in 1991 and a fellowship in academic Family & Community Medicine at Eastern Virginia Medical School (EVMS) in 1994.

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