“There’s no way you can move toward value-based care without incorporating patient-generated health data,” argues Danny Sands, MD, an internist at Beth Israel Deaconess Medical Center in Boston, Massachusetts, and an assistant professor of medicine at Harvard Medical School. In 2013, Dr. Sands served as co-chair for a panel of technical experts commissioned by the Office of the Coordinator for Health Information Technology (ONC) to create a comprehensive research report on the impact of patient-generated health data (PGHD). The report was conclusive in its findings: increases in patient-generated health data has the potential to improve patient experiences and overall health.
Physicians generally do not have access to real-time insights on a patient’s daily health data. This confines the opportunity to gain a holistic perspective of a patient’s health to clinical settings. Utilizing patient-generated data provides medical professionals with the potential to expand and improve patient-centered care.
While most technical experts agree that PGHD is vital to improving patient-centered care, many medical professionals have struggled to make practical use of the constant and growing influx of raw data facilitated by medical devices each year. Here are five ways healthcare professionals can efficiently facilitate and use patient-generated health data:
1. Use a secure patient-portal to keep track of a significant area of concern.
Dr. Jeffrey Pearson– a family physician in San Marcos, CA– regularly requests at-risk patients use a blood pressure cuff to track blood pressure or blood sugar rates after a visit to gain a more complete reading. The patient then sends a secure email message to Dr. Pearson’s patient portal, which automatically documents the data into his/her EHR.
2. Administer an online Health Risk Assessment (HRA) before an annual visit.
The Centers for Medicare & Medicaid Services (CMS) recommends physicians administer HRAs to gather information for annual Medicare Wellness Visits, however, physicians can administer an HRA for annual check-ups as well. Jeffrey Lederman, an internist in Long Branch, New Jersey, agrees that HRAs provide insights that physician may not be able to gain from an in-person interaction: “An HRA gives a great summary of the patient’s own self-awareness about their health care, and it can be very helpful to physicians.”
3. Deliver a pre-visit questionnaire for new patients.
Pre-visit questionnaires are among the more common methods of gathering patient-generated data. The most common of these questionnaires is the Instant Medical History—a survey that can be integrated with EHR systems such as NextGen, Cerner, Allscripts, and Greenway. The results are summarized into a quick and simple format to review and can save physicians up to four minutes to speak with and treat new patients.
4. Facilitate a functional status survey to measure how patients feel about their health.
Functional status surveys can be used to assess and manage the care of patients recovering from medical procedures. While many physicians see the data as superfluous, a growing number of experts such as Lisa Iezzoni, MD — director of the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston– have noted the value in measuring a patient’s internal progress throughout a recovery: ““I think there’s always an inherent validity to what the patient says, They’re the ones who are living in their body, they’re the ones who have to perform activities of daily living or get someone to help them with it. So even if a physician disagrees with a patient’s assessment from a patient-reported survey, it’s important for the physician to understand what the patient’s perceptions are.”
5. Refer patients to monitoring apps in order to identify potential irregularities.
Health monitoring apps have significantly grown in popularity, and the increase in captured data poses a unique opportunity for medical professionals to preemptively identify potential health issues. Ashish Atreja, MD– chief innovation & engagement officer and gastroenterologist at Mount Sinai Medical Center in New York–notes that integrating mHealth apps into patient assessments has benefited many of his at-risk patients: “For the patients whose GI symptoms are not controlled, we are able to see the pattern, and we are able to more proactively step up the medication, instead of waiting for them to come back in three to six months.”
SOURCES
https://www.healthit.gov/sites/default/files/onc_pghd_practical_guide.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454095/
https://www.pchalliance.org/news/effectiveness-patient-generated-health-data-routine-clinical-care
http://www.medicaleconomics.com/medical-economics-blog/how-harness-power-patient-generated-data