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Technology-enabled excellence in patient care
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Technology-enabled excellence in patient care 

Hovet, who ran a family practice for over 20 years before becoming a consultant said, she’s committed to transforming healthcare, and for her, health care transformation doesn’t mean bigger and better, it’s about delivering the right amount of care at the right time, right pace, and improving the overall level of health for the patient.

Accepting the tools we have

Using technology to better health care is not a new concept. Hovet pointed to a 2001 report by the Institute of Medicine (IOM), the health sciences wing of the U.S.-based National Academy of Sciences, entitled, Crossing the Quality Chasm: A New Health System for the 21st Century. The report focused on improving patient outcomes and laid out a set of health care rules for improving medicine in the 21st century. This included emphasizing new areas such as the using health IT to improve evidence-based decision making, bolstering transparency, and heightening cooperation between institutions and health care professionals. The IOM report established six aims that a 21st Century health care system should strive to be: safe, effective, patient-centred, timely, efficient, and equitable.

Hovet said the effective use of technology in health care could further ensure all these aims are achieved.

While it sounds great, technology is already ubiquitous in modern medicine. Technological innovations in nearly every specialty area have changed how patients are diagnosed and treated — is this already mission accomplished?

While it’s true ground-breaking technologies have transformed nearly every aspect of medicine, it’s the networking and sharing of the data being created by these tools that has yet to become pervasive. One needs only walk into their local clinic or family doctor’s office to see how much health care practitioners still rely on paper forms and charts. To truly achieve the goals laid out in the 2001 framework the focus needs to be on the solutions that connect the different branches of health care and enabled better patient outcomes. In practical terms, Hovet said the EHR (Electronic Health Record) should be the platform for change, preferably an integrated EHR — one EHR that incorporates all the information from various physicians and care givers a patient may seek treatment. “We’ve got to pull it all together,” she said.

Hovet said that as health care providers become more integrated with EHRs they can move from more episodic care to prevention and wellness management. Using EHRs contributes significantly to making evidence-based decisions, which is essential for improving patient outcomes. But in order for the tool to work, the information has to follow the patient wherever they may go. Health care providers need to be able to access the past information to build a care plan rather than simply treating current conditions.

Moving towards a platform

As we move towards using technology effectively in health care, Hovet said the system would pass through three stages. The first stage is the digitization of information; which will enable the second stage, the movement, exchange, and analysis of information; followed by the final stage, (and the desired outcome) of improved management of patient health. As you can probably guess, according to Hovet, we’re mostly stalled in the first stage.

Before information can be shared electronically, over a network, it must obviously be entered into a system or a digital representation of the physical document needs to be created. The digitization of information isn’t a difficult process to understand, but technologically, it can be fraught with complications. Issues of security, privacy, access, regulations, and standards have created a landscape of different EHR tools and solutions that may suit the needs of a single institution but lack the ability to easily communicate with other health care provider platforms. That inability to communicate removes the promise of digital records whereby providers can begin to measure and monitor patient information like never before.

Understandably, Hovet’s position is clear. “We need to unlock the information,” she said.

Digitizing paper records will not only be of benefit to health care providers, making storing, searching for, and sharing patient information easier and more effective than ever, but as Hovet explained during her presentation, it will enable patients to become their own primary care-givers. According to Hovet, it’s just as important to embrace technology for home care as well as hospitals.

Gaining acceptance

In order wide scale adoption of technology like EHRs to become reality the social barriers around the previously mentioned issues like security and privacy need to be addressed, and that’s not only for the health care provider but also the patients. In other words, not only do provider attitudes need to shift but patients need to feel comfortable with the technology as well. Much of that evolution starts not with tools like EHRs but with more commonplace technologies like smartphones and tablets. Providers must help patients feel comfortable with the technology by using it effectively and explaining its benefits as they go.

There is also no age barrier to using technology — according to Hovet, information technology tools in health care should be used for everyone — but a consistent approach should be used by the health care provider to ensure all patients, no matter what age and familiarity with technology, understand what is being done.

To effectively communicate the benefits of technology to the patient, Hovet suggests following what she calls the LEVEL method: let the patient Look on while you work to build trust, maintain Eye contact with the patient, Value the computer as a tool, Explain what you are doing to the patient, and Log off and say you are doing so. Using this method should help get patients more comfortable with clinicians using tools like computers, tablets, and other technology while the work, Hovet said.

In the end, Hovet said she believes the use of information technology tools like EHRs will contribute to the creation of a new reality in health care delivery, and it’s not only for collecting patient information, but delivery of health care to the patient. The end goal of using these tools is to optimize the health and well being of the patients and communities.

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