My Dog Gets A Print-Out From His Doctor, Why Don’t I?

Jackson

Jackson (Daryl Juran)

“Meaningful use.”

If you’re not in the medical records field, that term is, shall we say, not very meaningful. But it has the force of billions of federal dollars behind it. It’s a catchphrase central to the monumental national effort now under way to get medical records off of paper and into electronic forms that can be — yes, indeed — used meaningfully to document and improve health care.

The federal government is overseeing an elaborate, multi-stage process to work out the guidelines for the software designers who create these electronic medical records. As they do, Ken Farbstein, a professional patient advocate, has a low-tech suggestion to offer: Make sure the electronic records can and will be translated into printed instructions for patients.

By Ken Farbstein
Guest Blogger

My dog Jackson was born to a stray mother, and he never knew Daddy. Jackson has never had health insurance. Now entering old age (at ten), he definitely has some risk factors for poor health: uninsured, born homeless into a single parent family, aging. Yet he gets excellent health care, and of special note, he routinely gets much clearer doctors’ orders than I do.

At the end of each well-dog checkup, and at every other visit to the veterinarian, he receives a printed four-page summary that describes notes from the exam and, highlighted in red ink, the steps we should take to keep him healthy.

We weren’t brushing his teeth, so the visit summary included a paragraph on the plaque and tartar that develops with poor dental hygiene. It even recommended the specific flavor of toothpaste he’d likely prefer: poultry. (A human patient might go “Balk!” at that.) Years ago, when we found a lump in his left front shoulder, the visit summary described what a lipoma was, with our treatment options. In a later visit we heard a shocking diagnosis of a cancerous tumor. In later rereading the visit summary, we absorbed more of it than when we had first gotten the diagnosis.

The vet’s electronic health record software makes it easy for the vet and the technician to produce these summaries, so promptly that the payment clerk can routinely hand the printout to us at the end of the visit. The information in the visit summary is significant, actionable, pertinent, timely and specific; in short, it’s highly meaningful.

For example, when Jackson recently ruptured a spinal disk, the visit summary specified the timing, contra-indications, and pill-sweetening Pill Pockets (again in that yummy chicken flavor) for a pain medication and an anti-inflammatory (think canine ibuprofen), and the rules for a month of doggie bed rest: no running, jumping, stair-climbing; minimal walks; a harness to replace the collar, etc. The visit summary enabled us to engage actively in his recovery.

In spreading the use of electronic health records for humans, the powers that be are deciding what constitutes “meaningful use” by doctors of the E.H.R. They’re gathering comments from the public until May 7, 2012. We humans are just as deserving as our dogs; we too, should get doctors’ orders as clear as our dogs get.

If you agree, you can join with me and other patient advocates by signing this petition so that the Stage 2 and Stage 3 definitions of “meaningful use” shall routinely and promptly include printed doctor’s orders after an ambulatory visit, to build patients’ engagement in their care.

You can also make a comment yourself directly to the Office of the National Coordinator for Health Information Technology here.

That’ll give us meaningful use of the electronic medical record, in the consumer’s eyes – at a cost less than a dog biscuit.

Ken Farbstein is a professional patient advocate at Patient AdvoCare, and the author of Getting Your Best Health Care: Real-World Stories for Patient Empowerment. His previous post on a similar theme is “My Dog Has Better Medical Records Than My Daughter.”

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  • http://www.facebook.com/people/Darrell-Pruitt/100000062195250 Darrell Pruitt

    Not so fast, Carey Goldberg. If your vet’s computer is
    hacked, your dog’s EHR is worthless to identity thieves. However, if the EHR of
    you or a family member is stolen from your doctor’s computer, it can bring $50
    on the black market. What’s more, critical information in your EHR such as
    allergies will be altered to suit the thief. The poor security of EHRs has
    already caused serious harm to victims both financially and medically, while
    the frequency and severity are only getting worse.

    • http://www.facebook.com/people/Darrell-Pruitt/100000062195250 Darrell Pruitt

      For some reason, my comment was deleted. How did that happen, Carey Goldberg? You wouldn’t be trying to hide the truth from your readers, would you? 

      • http://www.facebook.com/people/Darrell-Pruitt/100000062195250 Darrell Pruitt

        That’s better. Thanks.

  • http://www.facebook.com/people/Darrell-Pruitt/100000062195250 Darrell Pruitt

    Not so fast, Carey Goldberg. If your vet’s computer is hacked, your dog’s EHR is worthless to identity thieves. However, if the EHR of you or a family member is stolen from your doctor’s computer, it can bring $50 on the black market. What’s more, critical information in your EHR such as allergies will be altered to suit the thief. The poor security of EHRs has
    already caused serious harm to victims both financially and medically, while the frequency and severity are only getting worse.

  • Spiritwriter1

    In response to the title of this blog, “If you were a patient at Harvard Vanguard Medical Associates” you would have gotten a printout for the last several years. I’ve been a patient at Harvard Vanguard for over 20 years, and they instituted this excellent practice many years ago. In addition, it contains a list of your next scheduled appointments with any HVMA clinician, a list of my allergies, and a list of current medications I am taking. Further, this “After Visit Summary” is available to me on line, along with all my lab reports and an email center where I can request a refill for a prescription that has expired or send an email to my clinician. I *love* it!

  • http://www.facebook.com/RebeccaCoelius Rebecca Coelius

    While what you are describing here overlaps with the functions of an EMR, you would more accurately compare it to a practice management platform like Hello Health or Avado. 
    I make this distinction because I think expecting our EMRs to be the one-stop solution for all tech-enabled activities in a practice is a huge mistake, and is leading to monopolies over practices and data silos. We would be better off expecting them to be data entry and storage devices only that aren’t allowed to own your own data, with separate product solutions that sit on top and help you interface with the data dependent on your intended purpose and practice setting. I’m interested in the SMART platform coming out of Harvard/CHO as they are going down this route, and opening up their platform to outside developers. 

    • Guest

      What is CHO?