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Linda Stotsky: A Lack of Electronic Data Exchange Capabilities Makes Caregiving “Dizzying”

February 06, 2017

The transition from having healthy parents to becoming a caregiver for ailing parents is a challenging experience many adults face. Add to it the difficulty of managing and exchanging data between providers, along with barriers to filling prescriptions, and it quickly becomes a “dizzying” task.

In the Q&A below, Linda Stotsky, health IT usability expert and HIMSS17 social media ambassador, shares her experience as a caregiver facing data exchange obstacles. She also reviews some of the key takeaways from Surescripts’ Connected Care and the Patient Experience Survey.

Q: Was there a fact or figure that stood out to you in the 2016 Connected Care and the Patient Experience Survey results?

A: I was surprised that only 4 in 10 respondents were less likely to visit a physician who does not e-prescribe. I expected this to be a larger number. When medications are prescribed manually, there are more errors and pharmacy/physician call-backs, making the process time-consuming for patients. In addition, delays at the start of medication therapy may cause patient and caregiver distress. Adverse drug events (ADEs) also occur more frequently, resulting in additional clinic visits and possible trips to the emergency room (ER).

As a caregiver, I found it virtually impossible to coordinate my mother’s care among multiple providers, as well as within the four walls of her residential long term care (LTC) facility. It was difficult to keep up with drug-to-drug reactions and allergies without real-time clinical decision support.

We were frequent ER visitors. I always brought along a paper copy of her medications, dosages and frequency requirements to avoid patient safety issues. My mom was severely allergic to Sulphur drugs. Antibiotics containing these chemicals could trigger a fatal reaction if prescribed. Far too often, I caught this just before it was about to occur. E-prescribing and medication management are more of a team approach to preventing an adverse drug event, thus reducing the likelihood of a fatal reaction.

Q: Did it surprise you that more than half of Americans are willing to share their mental healthcare data?

A: I was surprised. I believe we need to include mental health in our everyday conversations, but I did not expect more than 50 percent of Americans to be willing to share their mental health data.

As a psychiatric practice administrator, I’ve dealt with sensitive issues first-hand. Mental health information should never be a reason to penalize patients, yet in America we still attach a stigma to mental illness. When people are labelled due to their illnesses, they often become part of a stereotyped group.

Disclosing mental health problems in the workplace should never lead to discriminatory practices by managers and colleagues, but it does. All too often, micro-management increases and advancement opportunities decrease.

Q: In the 2016 survey, patients reported an average of 8 minutes spent verbally sharing their medical history per doctor’s visit, up from 6 minutes in 2015. Do you think 2017 will be the year that technology begins to make the process faster and easier?

A: We must place a greater emphasis on the way we communicate with patients. Better communication translates to more comprehensive patient records, resulting in less time spent going over redundancies. We must also decrease the amount of time physicians have to spend checking regulatory and compliance boxes in electronic health records (EHRs).

A recent study published in the Annals of Internal Medicine found that for every hour physicians see patients, they spend nearly two additional hours doing paperwork. In 2017, we can improve this process by reexamining the ways in which we communicate.

Electronic prescribing for controlled substances (EPCS) is one way to improve the process for patients and providers. EPCS greatly reduce call-backs and repeated office visits. I spoke with Gary Smith, MD, in Nashville today regarding EPCS. He said the service makes it easier for him to prescribe from any location. Plus, it provides full documentation of each script within his EHR. Thus, patient safety is increased and the time spent prescribing is reduced.

There are several other ways we can save time. “E-visits” free up time by allowing physicians to more quickly address simple health-related questions. Giving patients to access to all of their medical records also saves time by improving the reliability of health information and reducing redundant conversations.

In addition, it would be helpful if we made patient materials, such as lab results, more user-friendly by improving their design and usability. Ideally, patient-facing materials should be easy to interpret regardless of the reader’s language, age or education level.

Q: Telehealth technology is something that patients have come to want and expect. How can telehealth make a difference in 2017 and beyond?

A: 
Telehealth provides us with excellent opportunities to lower healthcare costs and decrease hospital readmissions through remote patient monitoring and real-time tracking. Telehealth easily fits into all of the areas mentioned above. It has many guises, from remote patient monitoring systems used by hospitals and rural health centers, to teleconsulting for second opinions and psychiatric screenings. Post-discharge monitoring and follow-up are both excellent uses of telehealth to reduce readmissions.

Telemedicine is an affordable care option regardless of geographic location or care setting. It takes the burden off emergency departments, which act as primary care offices for many consumers. The 21st Century Cures Act, signed into law on December 13, 2016, was a directive from Congress to further study the use of technology in the delivery of health care services. By reducing reimbursement barriers, we can maximize the use of telehealth throughout the healthcare ecosystem.

Attending HIMSS17? Don’t miss Linda and other industry experts as they join Surescripts at booth #6660 for a panel discussion about how e-prescribing and high quality prescription data improves medication adherence and patient care, while reducing hospital readmissions. Learn more today.

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