The Government’s vision to create a Health Information Exchange (HIE) has the potential to provide a comprehensive patient history at the point of care. In addition to this data exchange, Internet and “meaningful use” of electronic health records will have a positive and significant impact on the delivery of healthcare and its associated costs. This new arrangement will improve the collaboration among providers and health facilities.  The integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, and University of Pittsburgh Medical Center are extensively utilizing technology to improve access.  These big groups are combining doctors, clinics, hospitals and often some insurance and capturing the financial savings from electronic health records.

However, despite all the benefits, adoption of technology is slow in most of the small practices.  It is surely a change in “status-quo”, and as such small practices do not get financial incentives to use computerized medical records and for some practices it is very time consuming process to convert paper records into electronic records.

“And there are privacy and patient centered concerns as well” said Dr. Donald Tavakoli; a Philadelphia based Psychiatrist. “Obviously for psychiatrists, mental health issues and therapy notes raise a major concern of “discoverability” and differ from the rest of medicine (at least in some people’s minds).  Not to mention, typing with a patient in front of you, which happens a lot with electronic systems, takes away from the doctor patient relationship.  On the other hand, legibility, access to records, and streamlining for billing purposes can increase efficiency and decrease redundancy in testing etc.”

Dr. Tavakoli said “technology being incorporated into practice is a good thing as it increases access (as DocAsap proves), increases efficiency, and decreases risk of errors.  And at the end of the day, it is inevitability.  Increasingly, I’m hearing about things like Ipad’s being considered as notepads for clinicians, which could offer simply touch screen checklist items to mark off during evaluations, this not only reduces medical error but healthcare costs as well.  And it is possible increased technology and Electronic record systems dovetails with increased “checklist” medicine.  The big concern is that in healthcare, sometimes the art of medicine can have immeasurable value, and the doctor patient relationship is crucial (and mental healthcare tops that list, especially with psychotherapy, but it is true in all of medicine).”

Please check Dr. Tavakoli’s profile at DocAsap

Ever feel rushed by your doctor and forget to ask something?  DocAsap has compiled some online tips to help you maximize your next doctor visit:

• An AHA article recommends you bring a notebook to list out your questions and to take notes.  Also, slow down doctors to double-check instructions, and be bluntly honest with doctors.
• A Kaiser flyer also stresses honesty as well as repeating instructions and voicing disagreements.
• An amusing Men’s Health article recommends you “don’t rub your eyes or scratch your schnozz until you’ve treated your mitts with hand sanitizer” since waiting rooms are rife with germs.  The article also suggests you talk to nurses to get more information and see female physicians since they tend to spend longer amounts of time with patients.

Please add any other tips you have to share!

Health Affairs made available an article entitled “Take Two Aspirin and Tweet Me In the Morning”, which concerns patient empowerment via social media technologies.  It’ll be interesting to see how social media uniquely evolves in healthcare, as privacy issues loom and doctors might not buy in to it unless economic and clinical value is clearly evident.  Firms like Kaiser and Hello Health that are giving patients better access to care and more information are ones to watch, though the article also alludes to the nascent nature of such endeavors.   Furthermore, pure online treatment will likely only ever be an add-on to traditional offline doctor relationships, as you can’t take a shot, get a root canal or perform surgery via the internet (at least not now!).  Still, getting more information about and communication with doctors might radically improve access to care, something DocAsap is passionate about.

According to a recent Kaiser Health survey shared by Health Populi, more than half of Americans put off or reduced health care due to sensitivity to copayments and deductibles as a result of the recession.  Also, the rising ranks of uninsured due to mounting job losses adds to the number of patients who are not seeing doctors as a result of the recession.  While the stimulus bill did provide for a 9 month subsidy of COBRA payments to offset 65% the cost of insurance for laid off employees, this will not completely offset the recent increase in uninsured Americans, and won’t encourage those with insurance to see the doctor.  This decline in visits by insured patients provides much of the reason behind the recent financial troubles faced by many U.S. hospitals, such as U of Chicago, as well as the increased cost of floating rate debt due to the credit crunch.

Many hospitals are now facing the difficult decision of whether to cut their budgets in light of tightening operating margins.  We expect that as the economy stabilizes and as the COBRA subsidies kick in, patients will quickly make up for postponed visits.   We hope that economic recovery comes soon for the sake of patients and doctors.  Additionally, we at DocAsap look forward to helping doctors see more patients in the coming months as we launch our service.