Due to the interactive and real-time nature of an EHR, clinicians have a number of powerful tools at their fingertips that can be used to provide clinical guidance to patients and encourage healthy changes in behavior. With the advent of patient portals, personal health records, and mobile apps, there are now a number of additional mechanisms to use this information outside of the office visit.
EHRs are very good at presenting laboratory data and other personal metrics graphically in order to display trends and disease status. The following tips are provided to help you use graphs and data to motivate your patients:
- All EHRs are not the same and are continuously evolving to better support clinical care. Contact your EHR vendor directly to find out what is new in terms of data and graphical reports and features. As vendors regularly enhance their products in order to meet customer needs and comply with Meaningful Use requirements, they may recently have added new functionality which is not yet presented on the product websites. In addition, if you have a peer support group or user forum for your EHR product, contact your colleagues to learn how they are using their EHR to provide patient education and motivation.
- Consider the physical layout of your medical office and examination rooms in order to optimize the use of your EHR. Do you have monitors that are positioned to display graphs or clinical data easily to your patients during their clinical encounters? If you use a mobile tablet that is resting on your lap or on a table, it can be difficult to enter or share data, particularly if the patient is sitting opposite to you — a factor that may be limited by the physical design of your exam rooms. Similarly, desktop computers may also not be optimally positioned for information sharing. An additional wall-mounted monitor in a position that is easily viewable by patients can be a viable option.
- In addition, do you have printers easily accessible in order to provide a copy of a data report or a graph to the patient during the encounter? Although it is possible to print outside of the exam room, this frequently disrupts the encounter and consumes valuable time by forcing you to exit the exam room and return with the printed document. This is particularly important if using a networked printer where other print jobs may be queued in advance. Printers are inexpensive and new small-footprint devices can be very easily used in the exam room without any of the above limitations.
- Determine the types of reports and graphs you would like to share with your patients and try to standardize your requirements within the practice in order to develop a library of commonly used data formats. This will be easier to manage and can be consistently applied if you provide coverage for colleagues. If you are able to generate your own graphs and data reports on-the-fly and find formats that are particularly useful, ensure that you have a mechanism to bring these to attention of colleagues so that you can collaboratively support one another in order to achieve improved outcomes.
- Some of the commonly used graphical tools are used to manage patients with chronic diseases such as Diabetes Mellitus. An article published in Family Practice Management provides a guide on the use of graphs to manage Diabetes as well as the use of performance data within a medical practice for clinicians to benchmark their performance against that of their peers. While these graphs are focused on a specific disease state, the same tools and principles can be more widely applied in other clinical settings. For example, serial uric acid levels for patients suffering from gout or serial recordings of weight for osteoarthritis sufferers.
- Personal data is generally a stronger motivator, as it can be linked directly to a specific individual and their disease status. Where available, this is optimal type of information to use. However, there are also many resources available that can be used as reference guidelines if personal data does not exist for a specific condition.
- Patient portals provide an additional mechanism to share graphs and data in a format that can be accessed by patients at their convenience. If your EHR product offers a patient portal and it is used within your practice, make sure that you understand how data is presented to patients. For example, it could be in graphical or table format, which may be a bit more complex to interpret. Some EHRs provide analytical dashboards that allow patients to simultaneously graph different data elements in separate windows.
- With the popularity of smart phones growing, expect many EHR vendors to release mobile apps that will connect to their EHR and provide additional ways to share data with patients. By combining mobile apps and patient portals with email and text message reminders and notifications, patients can be alerted to new data and can be encouraged to check their results and dashboards in real-time — strong motivation to become more actively involved in their own care.
Have you used data or graphs in an innovative way in your practice? Share your experiences.