For a couple of years now, the primary care sector has been particularly focused on Meaningful Use. I recently posted about the impact of the Supreme Court decision on the ACA, and how John Loonsk, M.D. of CGI General commented that we need to look beyond the narrow view of EHRs optimized for Meaningful Use incentives to consider the broader opportunities for technology to transform the experience of care.
Hard on the heels of the Supreme Court decision comes a new report by the American Hospital Association that looks at the competencies of primary care physicians, both in practice and in their training. It shows that while primary care physicians perform well in four areas measured—medical knowledge, patient care, practice-based learning and use of informatics—there are two areas that get in the way of doctors properly contributing to the triple aim of lowering costs, improving the health of populations and improving the patient experience. These are; first, inadequate use of systems to manage costs and coordinate care across a care team and between providers and, second, limited interpersonal and communication skills with patients and within a care team.
Maybe we should start pushing for Meaningful Practice, not just Meaningful Use.
Accessible data, evidence-based guidelines and standardized reporting are certainly parts of primary care’s future, but we can’t simply practice health by the numbers—which the current phase of Meaningful Use encourages and incentivizes.
Other technologies now available to providers make the experience of care far more meaningful to a patient and to a care team. Technologies that make communication simpler, faster and more engaging are chief among them. But their adoption has been slow, even as the evidence mounts that patients love the enhanced relationship.
The next phase of Meaningful Use stipulates patient portals and greater patient engagement. I hope this will encourage more meaningful engagement with patients. I worry, however, that EHRs will simply evolve to support the specific requirements of the next MU rules, rather than truly energize the doctor-patient relationship, which was presumably the intent of the directive.
Closing the gap the AHA identifies requires much more than just a friendly smile and the ability to engage team members and patients with respect (although these are essential too!). Primary care needs to get comfortable with technologies that turn a practice on its head: from one centered on the doctor’s office to one centered on a patient, with a team and a communication platform that involve her deeply in her care and wellness.
A patient of one of our Hello Health physicians, a woman with physical disabilities, recently wrote to say how much more connected she feels to her doctor and to her care program now because she can communicate in multiple ways, check on visit notes, track her progress and more.
It’s rewarding for all of us to hear this kind of feedback. It helps justify our hard work, and the doctor’s commitment to change. Most of all, it shows that technology can genuinely enhance relationships with patients and improve their health. To us, that’s meaningful practice.