She experienced relief sooner: Effects of a patient portal

A story from Debbie Scammon, PhD:
I continue to be impressed with the fervor of MyChart (our patient portal) users regarding the benefits to patients of on-line access to their medical records. In one recent focus group with patients with longevity with our clinics (visits over several years), 5 of 6 participants were avid users and the other one was an admitted technophobe. The 5 users repeatedly asked how they could help the other patient “get up” on MyChart so he could start seeing the benefits. One patient dealing with migraines was excited that as she and her provider experimented with alternative medications to treat her headaches she could report after each dose how she was feeling and how the new medication was working. With this ability to share her experiences with her provider in real-time, adjustments in dosage could be made quickly and the patient experienced relief sooner. Another patient pointed out to the group that he (at home), and his provider (during a visit), could see graphs of his health status over time (back years) and thus have a better idea of how he was progressing. Yet another patient was elated that when she tried to schedule a routine preventive screening, she found by looking at her records in MyChart that it wasn’t yet time for that exam and thus she was able to avoid an unnecessary test, one that would not have been covered by her insurance. Access to her medical record on-line gave her more control over her healthcare and a feeling of enhanced self-management.

These are exactly the sorts of benefits hoped for from the implementation of our patient portal. I’ve definitely seen that patients want to help each other gain access to the portal so that they can begin to take more control over their health.

See another of Debbie's stories, on seniors' use of social media.

Thanks to Debbie Scammon for this, based on her research project, “Transformed Primary Care - Care by Design,” funded by AHRQ (U.S. Agency for Healthcare Research and Quality) Grant # 1 R18 HS19136, and led by Principal Investigator Michael Magill, MD.

I see seven!: Use of social media by seniors with multiple chronic conditions

A story from Debbie Scammon, PhD:

We are trying to reach our most fragile patients, the ones with multiple chronic conditions, who have extra needs for supportive care. I led a focus group a couple of weeks ago with ten patients, all over 60, all with at least one chronic condition. We thought people like that might be especially hard to reach with a patient portal. But every one of them HAD been on our portal, which we've had only since the Fall 2010. Nearly all of them had been looking up their test results there, after an appointment, to check the posted test results, because, they even said, they wanted to put them on Facebook! Why? I think so they could show off to their friends, even small successes, like: "I got my blood pressure under control!" or "I walked an extra mile," or "I lost five pounds!" They'd look forward to getting congratulated by their peers, getting accolades; they want that pat on the back. It might be more meaningful to them when it comes from someone who understands the situation they're in, even more than from a doctor.

Later on in that same focus group, one patient who'd been a patient advocate in a community organization raised the possibility that patients with similar conditions could start a peer support group. It was notable to me that they weren't dependent on healthcare providers for that; they wanted to be there to support each other. The information shared was that vital to them. For example, one member of the focus group had said, "I wish my care team didn't ask me what meds I was on every visit." Another member of the group responded, "That's because you only see one doctor; I see seven!" So the light bulb came on for the one who was objecting to the medication reconciliation; she said, "Now I get it!" They're able to explain to each other in understandable terms why things are happening with their conditions and their care. That's really powerful. That's the whole basis of social networking.

There's a great positive opportunity for using social media, especially electronic media, more generally to engage patients and facilitate their communication with each other.

Debbie Scammon's advice to seniors with several chronic conditions: Learn to take advantage of the "power of many" available from your peers both on- and off-line.

Thanks to Debbie for our interview in June 2011. See the executive summary of one of her recent articles.