"I go over, okay, so what is your problem, what at least is in my mind as to potential causes of that problem, and then how would any tests or treatments truly change management, and then what's our stepwise plan?" he says. "What are we doing, each week, until I have you better? And then lastly, what are your thoughts and concerns, from the patient side? And so that's how I've structured things."
"It's interesting that everyone has a slightly different take on what they think would be an important outcome measure to show," Freedman says. "Insurers want whatever the trial is by whomever to show decreased cost, and that at least you don't worsen healthcare quality." But the project won't truly succeed unless it shows patient engagement, he adds.
A paper-based pilot study found patient satisfaction rising from 34 percent to 94 percent being satisfied with having a plan of action from their doctor. "People were actually astounded that they had a simple plan that they could then follow," Freedman says.
"The EMRs are essentially a one-way archive," Freedman says. "We dump in lots of data—your lab results, imaging—and the patients really don't have very good access to it, and if they do, it's in a language that's, for the most part, not understandable to them, and that's why we're trying to create this."