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as technology becomesa more important part of people's lives,the opportunities are expanding for patientsto use technology to manage theirhealth information. healthcare providersare beginning to develop online patient portalsthat allow patients to access theirhealth records and communicatewith their providers. we are just at the beginningof this kind of innovation.
there's a huge, huge rolefor it to play in engaging patientsin their healthcare. you know, if you stopand think about all the things that we do as individualsonline today, you know, we buyour airline tickets or we do ourholiday shopping, or we, you know,check our stocks, or we-- there's a thousand thingsthat people can do online, but interacting withour healthcare provider
and getting a glimpseinto our medical record the way we can lookat our bank statements just doesn'thappen very often. so, i think if weas a nation really want to engage patients in theirhealth and health management, we've got to really pushthat online access to your providerto your record in order to getthem engaged and get them to understandtheir health
and theirmedical conditions and start to managethose better. i absolutelythink that that consumertechnology space is gonna be a majorpositive disrupter, and as people have accessto their information as they have the attitudeand the cultural shift on the part of patientsand providers that it's okay for patientsto be partners in their care,
and as there are nowa whole ecosystem of apps and servicesthat help people choose a provider,find out what things cost, make an appointment,manage their health-- those three things:access, attitudes, and action are gonnacompletely disrupt, in a very positiveway, healthcare. patients are starting to wantaccess to their information. they've got access to a lotof other information
about their lives now. everybody's walking aroundwith a smartphone, everybody knows wherethe best-rated restaurant is in their area,and they're starting to say, "why don't i have accessto the same kind of informationin healthcare?" now, there's some rulesthat you've got to follow, there's some very carefulconsiderations you've gotta make when you're thinking aboutthe privacy and security
of health informationthat's not quite the same as a restaurant review,but nonetheless, we really should stillbe able to have access to our ownhealth information, and not just accessto it, but in a way that makes sense to us,that's usable to us. we're participantsin our care, and that's reallyimportant for us to be ableto get good care.
but i thinkthe bigger difference is fundamentally,it can make the partnership between the patientand the provider facilitatedby that screen. instead of the screenbeing between the doctor and the patient,the screen and the information reallycan be that third party that they're bothlooking at. if we can both lookat the same information,
both of us,the patient and the doctor look at the sameinformation, that unlocks an entirely newdynamic for patients of relating to their ownhealth and healthcare. if i can seemy records, which is my right,by the way, right? everyone hasthat legal right, but how often do peopleexercise that right in a paper-based world?
not that often. but withan electronic world, it's becoming partof healthcare, the same way it's becomepart of banking, the same way it's becomepart of telecom. the same way it's become part ofevery other aspect of our life, we expect to seethat same information that our serviceprovider is seeing, but in medicine, even thoughit's been our legal right,
we haven't actuallymade it easy for patients to see what you're seeingas a doctor, and that's changingas part of meaningful use. the good news ispatients are so savvy now with technology, they reallyexpect you to know how to get their informationand get it presented in a very visual way,so it's been interesting to watch some of our physicianslearn to cope with, "here's my chart" now,and invite that patient
into that collaborativediscussion of, "this is whati know about you, and this isthe information. now, tell me more. what's changed?" and they actuallysee the physician updating their record,and of course, we're very excitedabout the long-term goal of having the patientactually access information
in this electronic world. so, i think that has beenthe most exciting change for us withthe technology. one of the thingsthat's happened right now is to sit downwith the patient, and our practice havetaken the standpoint that we chart,except for the final plan, right in frontof the patient, and they see whatwe're putting in,
they see whatwe're writing. for example, i hada patient yesterday that the diagnosis of obesityflashed up on the screen. it's a true diagnosis,but the patient was like, "wha--why isthat there?" and we explained thather height/weight put her in that category,and it hit home that her weight was somethingshe was gonna have to deal with. and so, it gave methe opportunity
to sort of engage her in that,"you meet this criteria." we've seen thatwith medications. "oh, i don'ttake that." "oh, i know i'm supposedto be on this, but i don'ttake it anymore." so, with medicationreconciliation, while it isan extra step, something most peoplearen't used to doing, we're seeing--we're finding--getting a more accurate picture
of what our patientsare actually taking. most of us see physiciansall over the city, and sometimesin multiple cities, and there will be an opportunityfor patient portals and such devices wherea patient can go in and say, "you know, i hada reaction to a medication when i was outin california," and they can enter that allergyinto their system back home so that their physicianhas that information at hand.
if they have a testdone somewhere else, they can have that done;if they get their flu shot at one of the localdrug stores, they can go onlineand document that so that that information'savailable to the physician or primary physician when they go see them at the next visit. you know, i can seea situation down the line where patients, before theycome in for a visit,
will also get onand update their histories, answer a brief surveyabout what symptoms they have, what's going on,any concerns they have, so they can make surethat that information is presented tothe clinical staff when they comefor their visit. social mediaapplications, like other technologies,have exploded. while there are manypositive possibilities
for social mediain healthcare, there are alsosome cautions. the current stateof healthcare provides a lotof great tools in providers' offices,in hospitals, in pharmacies. we're seeing a developmentof health information exchange capabilities in somepatient-facing technologies. i'm really expectingover the next five to ten years that a lot of the changesin technology
that we're seeingin the broader market, whether this issocial media or other kinds of personalizedaccess to your information are gonna become a lot moreprevalent in healthcare. some people talkabout apps, i can definitely see itworking that way. we might have sudden changesin the architecture that none of uscan really anticipate, but the key thing isthat we should expect
that information is goingto be made available to us in a way that'ssignificant for us, whether it's "us" the doctoror "us" the patient or "us"the policy maker, we should expectover the next five to ten years that the information flowsare gonna become a lot more tailoredfor individuals. there are many organizationsthat are using social media to enhance the customerrelationship management,
and it varies fromcustomers forming communities around products and servicesand sharing best practices with each other and sharingtheir enthusiasm and their gripes, and i thinkthat healthcare organizations need to dothe same thing. i think whatthat comes down to in the short runis organizations have to havea social media strategy. they've gotta understandwhere they want to be and why.
they've got to put someconstraints on it as well. they've got to educatetheir workforce about their conductin the social media, and if they'resmart about it, i think that there'san awful lot of leverage and an awful lot of publicityand energy in the social media and in facilitating communitiesin the social media, whether it's morepatient-oriented or moreconsumer-oriented,
that the smarthealthcare organizations are actually doinga good job on right now. i think it can improveoutcomes for individuals because in many cases,especially complex cases, where you go to seea specialist and you interactwith a doctor who understands thisvery, very well and speaks to you in a languagethat's mostly greek and latin and maybe gives yousome things to read,
but it's not quite the sameas interacting with other people who have the diseasewhere you can ask questions and not feel likeyou're being dumb or ask for thingsto be repeated. so, i think it's a veryvaluable interaction for patients who are willingto participate in that, and i wish more doctorswould be-- i think they are gettingmore open to this, but i wishmore were
open to connectingup their patients to talk to each otherabout these issues, because some of the thingsthat you have to do when you have thesepeculiar diseases, they don't make sensefrom a layperson's point of view, but if you talkto a bunch of other people and they say, "oh, when i triedthat, this is what happened," and, "yes,"you know. on the other hand, there's a lotof garbage out there, too,
and the interactionbetween the patients who are recommending things to each other and the scientific communitythat can say, "yeah, we see why you'resaying that, but look, here's what'sreally going on, and that's actually gonnahurt or not do anything. why don't you tryone of these things, which have been scientificallyshown to be more useful," and they get that backinto the conversation.
there's a,almost a chinese wall between the patient interactionsand the scientific community that i hope goes awayas this phenomenon spreads. looking at the future,i'm incredibly optimistic. sometimes in healthcare,people who have been around healthcarefor a long time, they feel, "oh, healthcare'snever gonna change." i actually think thathealthcare is changing, and i'm incredibly optimisticat the direction of the change.
the first is,as an infrastructure, we're gonna havehealth it. we are passedthe tipping point. the majority of healthcaredelivered in this country, by the end of this year,i believe, will be delivered throughelectronic health records in doctors' officesand hospitals. so, that's the firstnear-term thing is it's gonna go in a shortspan of a few years
from something that wasan unusual thing to do in these fewbenchmark institutions to most care in this countryis gonna--and increasingly, it's gonna be unusualif healthcare is not gonna be delivered withelectronic health records, and that'sa good thing. health itis gonna break out of electronicmedical records for doctorsand hospitals.
it's gonna be embedded inthe consumer technology space. there are now tensof thousands of medical apps, and increasingly it's beingseen as something that actually is gonnahelp people stay healthier. help people taketheir medications, the right medications,help people connect to otherswho have the same problem and get advicefrom those other patients. there's gonna becompetition and gaming
about how wellyou control your weight or how well you controlyour blood sugar. there's gonna be waysof managing your healthcarefinances. it's so complicated,it's too complicated, and we could alluse some help. i know that when my dadwas--left the hospital and i had a kitchen tablefull of bills and explanationof benefits,
and it was anythingbut an explanation. so, why can't i getsomeone to help me take all that informationand help me manage my health, my dad's health,my healthcare finances? and that's coming. if the past five to ten yearshave led to increased adoption of health informaticsfor doctors and hospitals, the next decade will seehealth it applications with a focuson the patients.
patients will routinely accesstheir health information and share it whenthey change providers. applications willbe more tailored to the needsof the individual. there will be shareddecision making as patients becomemore engaged, and both doctorsand patients have access tothe same information. social media is being embracedby healthcare providers as well.
it can be used to enhancecustomer relations by providing new meansof communication between the patientand the provider. online support groupsfor patients can provide accessto sources of information that have not beeneasily available to patientsin the past. as with any new technology,we can expect to discover unexpected advantagesand challenges,
but we can expect the nextten years to be the decade of the technologically savvy,engaged patient.
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