Q&A: Farzad Mostashari on Meaningful Use, Privacy

HLM: Patient engagement is a priority under healthcare reform. How do you respond to the argument I hear a lot that physicians really can't lead disengaged patients to water?

Mostashari: I think there's a germ of truth to that. I think in many ways we (patients) are the ones that are most responsible for our own behaviors, for taking our medications, and for going to the doctor's office in the first place. But I think there is something to the other side too. If we (doctors) get our hackles up when patients ask for copies of their records, which is all too often the approach that some providers have taken, then it changes the conversation.

One of our meaningful use vanguards says 'I love it that the patients correct my medical records. I have an army of fact checkers who care more about this than anyone else possibly could. I give them a copy of their visit notes and they help me correct their records. They tell me what medications they are on that I don't have on my list. They help me fix the diagnosis or whatever else is in my record. I use that as a tool to help engage with the patient, their family and their caregivers.'

There is a difference in providers who don't put the computer screen between them and the patient, who really use the information tools as a way to engage with the patient, and who say to the patient: Look at what I am typing or look at this graph. Here's what is happening with your blood sugars. Log onto a portal and look at your lab results. Feel free to send me a message.

What they find is that patients don't abuse those tools. Not all patients want to, but a lot of patients take advantage of those tools. It does make a difference.