Integrating a Physical Office With an Online Platform
Integrating a Physical Office With an Online Platform
If you were to start from scratch and design a medical practice that helped patients and physicians collaborate, reduced the inefficiencies inherent in traditional clinical encounters, improved patient access, and reinforced quality care–what would that look like?
Over the past several years, the health care industry has focused on a variety of strategies and models to address these issues, including electronic medical records (EMRs), clinical groupware, personal health records, patient registries, and medical homes. All of these are viewed as important pieces of the puzzle for creating integrated, high-quality health care delivery networks. Physician practices have started to more widely adopt electronic systems to track patient care, particularly around health maintenance and chronic conditions such as diabetes and heart disease. In 2010, data from Centers for Disease Control (CDC) and the National Ambulatory Medical Care Survey (NAMCS) found that 50% of office-based physicians in the US use some kind of an EMR system, up from 18% in 2001. In some respects, the trends are encouraging.
The problem is that most of these solutions must be embedded or retrofitted into existing practices that have workflows and processes that do not easily lend themselves to participatory medicine. Furthermore, the process of adopting an EMR system is an expensive commitment for most medical practices, with costs as high as $120,000 per physician in the first year of implementation. An even bigger impediment is the reimbursement structure of health care, which rewards volume over quality and leaves little room for physicians to explore innovative modalities that focus on enhancing the patient-doctor therapeutic relationship. Only a few physician practices have had the luxury of undertaking the necessary retooling of their practices to enhance clinical interactions, patient participation, patient access, and continuity of care, ingredients that are essential to increasing the quality of care in a patient-centric environment. It should, therefore, come as no surprise that the 2010 CDC/NAMCS report found that despite the increase in the use of electronic systems, only 10% of physicians have a "fully functional" EMR system that may enable them to meet the meaningful use criteria as defined by the US Department of Health and Human Services (DHHS).
For the past several years, coauthor Khozin has explored new approaches to addressing these challenges by developing a system that was designed from scratch to fully integrate office and online systems. His efforts were based on the hypothesis that improving health outcomes requires redesigning the care delivery paradigm so that it empowers both patients and physicians. This article describes the strategies he chose, practical experiences, challenges faced, and implications for future efforts.
Abstract and Introduction
Introduction
If you were to start from scratch and design a medical practice that helped patients and physicians collaborate, reduced the inefficiencies inherent in traditional clinical encounters, improved patient access, and reinforced quality care–what would that look like?
Over the past several years, the health care industry has focused on a variety of strategies and models to address these issues, including electronic medical records (EMRs), clinical groupware, personal health records, patient registries, and medical homes. All of these are viewed as important pieces of the puzzle for creating integrated, high-quality health care delivery networks. Physician practices have started to more widely adopt electronic systems to track patient care, particularly around health maintenance and chronic conditions such as diabetes and heart disease. In 2010, data from Centers for Disease Control (CDC) and the National Ambulatory Medical Care Survey (NAMCS) found that 50% of office-based physicians in the US use some kind of an EMR system, up from 18% in 2001. In some respects, the trends are encouraging.
The problem is that most of these solutions must be embedded or retrofitted into existing practices that have workflows and processes that do not easily lend themselves to participatory medicine. Furthermore, the process of adopting an EMR system is an expensive commitment for most medical practices, with costs as high as $120,000 per physician in the first year of implementation. An even bigger impediment is the reimbursement structure of health care, which rewards volume over quality and leaves little room for physicians to explore innovative modalities that focus on enhancing the patient-doctor therapeutic relationship. Only a few physician practices have had the luxury of undertaking the necessary retooling of their practices to enhance clinical interactions, patient participation, patient access, and continuity of care, ingredients that are essential to increasing the quality of care in a patient-centric environment. It should, therefore, come as no surprise that the 2010 CDC/NAMCS report found that despite the increase in the use of electronic systems, only 10% of physicians have a "fully functional" EMR system that may enable them to meet the meaningful use criteria as defined by the US Department of Health and Human Services (DHHS).
For the past several years, coauthor Khozin has explored new approaches to addressing these challenges by developing a system that was designed from scratch to fully integrate office and online systems. His efforts were based on the hypothesis that improving health outcomes requires redesigning the care delivery paradigm so that it empowers both patients and physicians. This article describes the strategies he chose, practical experiences, challenges faced, and implications for future efforts.