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Ready or Not, Tech-Savvy e-Patients are Coming

Gienna Shaw, for HealthLeaders Media, May 25, 2010

The patient of the future—also known as the e-Patient—is technologically savvy, information hungry, and has a sense of entitlement about the level of service and the types of services they want. They'll demand up-to-date, easy-to-understand, and easy-to-access information about the cost of care and billing, online appointment scheduling, the ability to e-mail their physicians, and hospital Web sites that have more information than can be found on Google maps. The patient of the future will put plenty of demands on  healthcare organizations in general and healthcare IT departments in particular.

Donna Cryer is one such patient. A liver transplant recipient who's had to deal with multiple and complex health issues starting when she was just 13, she wants to be cared for in ways that can only be delivered with data-sharing and expedited communication.

I interviewed Cryer for this month's HealthLeaders magazine cover story, Time to Put Patients First: How America's hospitals have lost touch with their top priority—and what healthcare leaders are doing to fix it. The story is about the patient of the future—including how technology can help meet some of their needs. Unfortunately, we didn't have room to run her comments, so I want to share some of what she said here.

"Patient-centered care is individualized, personalized treatment decisions that [are] placed in the context of the patients' entire life," she says. Each person has individual goals for who they want to be, how healthy they want to be, what their own risk benefit analysis is for a given treatment, she says. For example, when Cryer was still in her teens, her surgeons recommended she have her colon removed.

"I just really wasn't able to face that . . . spending my teenage years with an ostomy bag. So we did it in my twenties," she says. "My medical team works with me and I work with them . . . It was my decision to make and they were coaching me through that calculus."

Although Cryer has good things to say about how patient-centered her healthcare provider is, she says the organization falls down in other areas, especially when it comes to technology.

"The Web site is totally inadequate—I can't get any useful information," she says. No online appointment bookings, difficulty finding parking, wait times that range from several weeks to months long waits for results of labs tests that were finally delivered via snail mail. And when she finally got them? "They weren't shared with, well, anybody."

After getting the test results, she went to an appointment with a specialist. She didn't bring the lab results or her "truckload of files" because she had heard they were finally instituting an electronic medical record.

She should have brought them.

"I am the conduit for all tests results and information to my physicians. That is my current challenge in healthcare—meaningful access to my physicians [is] supported by the most meager amount of technology," she says. "Patient responsibility—I'm a big fan, but it's too much even for me . . . it's not really appropriate for me to take on that role . . . This role as über-coordinator is beyond even someone like me who can do it pretty much full time."

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