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EMRs’ big gaping hole of secure messaging

Today’s post begins a series inspired by my recent participation in a breakfast panel in Washington, DC, Doctors and Patients Bridging the Digital Divide. There were a lot of useful ideas discussed during this panel, and so I decided to capture and share some with you.

One of the biggest holes in electronic medical records currently seems to be a lack of secure messaging systems built into the software.  Although maybe not universally true, this still represents a huge problem that also represents a great opportunity for gains in technology that will enhance the doctor-patient relationship and move digital healthcare forward into the future.

Currently, my electronic medical record vendor does not supply this feature as part of its software package.  However, as part of the Meaningful Use Stage 2 requirements by the federal government, the use of a certified EMR system that supports this function will be required.  A HIPAA-compliant secure messaging system will be needed as a part of every electronic medical record going forward.

Currently, if I wanted to use secure messaging to communicate with my patients, I would have to purchase a separate third-party vendor’s online software to communicate in a HIPAA-compliant fashion.  This involves an additional service agreement between the third-party and me, as well as monthly fees they can be expensive.  This would grant me the right to not only communicate with patients but also to bill third-party insurance companies for providing such electronic health services.  However, what may people do not appreciate is the small reimbursement allowance for such services, which is quite minimal.  Thus, regardless of the demand by patients, it’s currently more financially lucrative simply to see another patient in the office for a follow-up visit rather than answer a message electronically.  If an electronic medical record vendor builds secure patient messaging into their platform, when there is already a contractual arrangement between the doctor and EMR vendor, then a third-party cost would potentially become unnecessary.  The prospect of using a built-in, HIPAA-compliant, secure messaging system suddenly becomes much more attractive and potentially fiscally responsible.

Unfortunately, many EMR systems are in still developing stages at which they do not yet have built-in secure messaging features in their PHR or personal health record modules.

But what a wonderful and potentially powerful area for future development in order to further promote patients to become more engaged in playing a more active role in their own health care.  The ability of a patient to reach their doctor through the Internet is certainly an attractive feature if done right and seems potentially better than a patient spending five minutes on hold listening to elevator music only to finally speak to a front desk staff member who will only be able to forward a message, which may or may not be forwarded accurately.

September 12, 2012 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Doctor-patient relationships with EMRs: a new menage a trois

Now before you go thinking this is going to be some dirty sex blog, it’s actually not.  According to Wikipedia, menage a trois literally translates as “household of three”.  I finally made another breakthrough in the past two weeks.  I’ve been thinking of ways to stretch seemingly limited space to bring on another endocrinologist in my office.  It just so happens that business is booming and it’s time to consider branching out to keep up with demand.

Now a funny thing happened on the way to the forum, as things always seem to do.  In an effort to get my patients out of the exam rooms quickly — in order to allow another potential provider to use the room — I began seeing them for the majority of the visits in my actual office.  These days I begin the visit with a brief two or three minute physical exam.  Then I invite them into my much larger and more sunlit office overlooking M street.  (This is the part where you’re supposed to say ooh-la-la!)

Well wouldn’t you know I hit a new eureka moment when I was suddenly able to type while only moving my head a little between the patient’s face and the computer screen.  Aha!  A new intimacy was suddenly upon us.  I could complete the medical interview while feeling like we were actually having an intimate discussion across the top of my big, swanky K-mart mail-order (shhh…) desk.  What’s more, we were out of the sterile exam room environment and the patients seemed more relaxed and comfortable.

It seems that the more I practice medicine using my EMR system, the more I find new and creative ways of bringing it into my relationship with patients naturally and effortlessly.  All the more positive reinforcement to practice, practice, practice…

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

June 23, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.