Lygeia Ricciardi, the ONC's senior policy advisor for consumer e-health, pointed to a three-pronged approach to patient engagement -- to provide secure and timely access to personal health information, to change attitudes about access to and use of PHI to engage in health care, and to encourage the adoption of tools that let patients use PHI to take positive action.
Current initiatives to that end include HealthIT.gov, an educational resource for both patients and providers about the benefits of electronic health record (EHR) systems, and a partnership with Challenge.gov, a government site soliciting solutions to acknowledged issues, including the Healthy Apps Challenge from Surgeon General Regina Benjamin, M.D. There's also a patient engagement pledge program, in which more than 250 providers, payers, advocacy groups and IT vendors vow to support easy patient access to PHI.
That, though, is only the beginning. Ricciardi pointed to four technology and policy "frontier issues" the ONC expects to face in its push to boost patient engagement. Each brought with it additional concerns, which members of the health care community shared during a question-and-answer session with Ricciardi and two other ONC staffers.
Bringing patient-generated data into EHR systems. This dilemma is equal parts technical, given the numerous barriers to patient portal adoption, and cultural, given the industry's "cultural discomfort" regarding information exchange, Ricciardi said. Even home health and hospice providers, ardent advocates for telehealth technology, struggle to integrate the patient data they've collected into their networks' EHR systems.
Judiciously using social media. The goal, Ricciardi said, is to "make social media more amenable for patients to use, perhaps, in combination with their providers." However, organizations that draft a health care social media policy do so in the absence of federal regulation, and ONC has not yet "enumerated the issues that you [providers] have already identified."
There are four technology and policy 'frontier issues' the ONC expects to face in its push to boost patient engagement.
Providing proxy access to PHI. This is critical, as nearly everyone who leaves a hospital does so with a caregiver in tow. While secure mobile health may be an option, certain mHealth applications may be inaccessible to those in underserved populations and could, in fact, further alienate patients and worsen health disparities. Lack of foreign language support could also hinder patient engagement in this case.
Putting information about cost, quality of care, treatment and outcomes into context for patients. Here health care organizations must walk a fine line between medical jargon and overly simplistic terms that could be misconstrued as talking down to patients. Either scenario here, too, could further alienate patients. Expanding patient education, in large part by capitalizing on the value of libraries to underserved communities, would be a good start.
Ricciardi admitted that the ONC is pushing "relatively new ground" in its patient engagement efforts, which include health IT education videos in English and Spanish, a crowdsourced video contest that will run throughout 2012 and numerous "interesting and inspiring" personal stories of how people use IT to improve health care.
Through these efforts, the ONC hopes to be a "catalyst of change" through which health care providers give patients enough information so they can take action to improve their overall health. More patient engagement would be good, Ricciardi said, but more effective patient engagement would be great.
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