New IT system features 'e-office visits'

WASHINGTON, Dec. 28 (UPI) -- Fifty-four thousand patients in a large medical practice near San Francisco are logging on to a Web site to get lab results, renew drug prescriptions or cancel a doctor's appointment, showcasing a successful health IT microcosm that computer experts hope the entire nation can eventually emulate.

The patients in that California practice are using a nascent system called the Personal Health Record, a system that will introduce next year the "virtual office visit" for simple ailments like the common cold in place of a trip to the doctor's office.

Paul Tang, vice president and chief medical information officer for the Palo Alto Medical Foundation who helped develop the system, told United Press International that PAMF created the tool to give patients more transparent access to their personal health information and help them become more active participants in the healthcare process.

"The healthcare system needs to take advantage of electronic tools," Tang told UPI. "It will allow us to make better decisions and help patients become more actively involved in managing their own health. If we can make electronic health records and personal health records universal, we can transform healthcare and really improve the wellbeing of the U.S. population," he said.

Tang noted that fast access to lab results has especially drawn accolades from patients with chronic conditions.

"It's one of the features patients tell us they like best," Tang said. "Access to their lab results gives our patients feedback on how their behavior and lifestyle choices affect their condition and tells them how well they are managing their diseases. If they don't have this feedback, a good proportion will only take half of the pills they've been prescribed," he said.

Other patient favorites include being able to communicate with a doctor through online secure messaging and having access to information on diagnoses, medications, immunizations and health maintenance schedules, such as mammograms, Tang noted. With patients' permission, ER physicians and doctors' offices around the country can obtain this information as well, he added.

Tang noted that PAMF keeps the doctor/patient lines of communication open 24 hours a day.

"Patients find the convenience of being able to send us a message anytime and from anywhere particularly useful," he commented. "They can send their doctor a question whenever the question occurs to them, 24 hours a day. Most of the time the doctor gets back to them in half a day, although we say that we'll respond within one to two business days."

He added that the PHR's range of capabilities is still evolving, with two new features to be launched next year.

So-called "e-Visits" will allow patients to interact with their doctors online for simple problems such as colds and allergy symptoms instead of having to come to the office. The online disease-management feature will involve patients with conditions such as diabetes sending data from home monitoring instruments to their doctors on a frequent basis and getting feedback on the next steps they should take to maintain their health, Tang said.

"Online disease management will be more convenient and our patients will get better care than if they came to the office every three to six months," Tang said. "Their conditions will be much better controlled and they will have fewer complications because we can track their progress more closely and catch problems early."

Currently, PHRs offer a range of other functions, such as allowing patients to ask billing and non-medical questions; view a personal health summary of all their interactions with PAMF since their first visit; see what tests have been ordered; see graphs of their progress controlling weight, cholesterol, diabetes, high blood pressure or other chronic conditions; and check their risk of developing acute problems such as heart attacks or strokes.

Tang said that, although paper-based practices can use PHRs, the system works best when a practice already has an electronic health record system and all the relevant patient information can be linked.

He added that the government's Office of the National Coordinator of Health Information Technology, headed by David Brailer, is developing infrastructure that will connect PHRs nationwide.

When the system is complete, patients will be able to allow doctors in any emergency room or office in the nation to access records from all their physicians and will be able to see an overview of all their caregivers' results and conclusions, Tang said. He said he believed privacy issues will be handled via a password system.