Sunday, February 21, 2016

Is the online-patient-record a very useful communication tool?

Once most doctors realize that the online-patient-record is potentially a very useful asynchronous communication tool with ample opportunities for patient-follow-up (informational continuity) they are likely to warm up to it. 

It took time for a majority of people to warm up to asynchronous SMS over synchronous telephone calls but once they realized the benefits (minimal intrusion on one's personal time space) people lapped it up and when WhatsApp arrived with more value addition to the SMS it touched the skies?

In their day to day workflow much time is lost by doctors communicating on telephones and most of these conversations are not even recorded but some of it is later distilled onto paper based records. 

On the other hand EHRs can considerably reduce this telephonic time taken for each patient. 

Even in non-standardized online-patient-records that are connected to closed-social-media (part of our hospital and community patient-workflow), when the senior consultant wants to know the follow up of any patient (at any time from his/her residence) all s/he needs to do is enter 'update' and tag whichever on-duty-resident/nursing-staff is present in the hospital at that time. S/he's sure to have the answer within a short-while from the duty-person who types the necessary patient-information below the same comment thread (and the entire information exchange is later saved in the online-record in a space that is not a part of the main record but can be accessed at one click if/when needed). For example: (scroll to bottom for today's update).

Same goes for the patient who is currently in the community (where this response comes from the community health worker who creates and manages the patient's non-standardized online-health-record). 

An important point that needs to be addressed for scaling such models is 'training' to create efficient health-user-ecosystems and one of the biggest stumbling blocks to these is our current medical education curricula which encourages lecture-classes and rote memorization over patient-centered-learning?

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