The Personal Health Record — A Potential Hedge Against Rising Healthcare Costs
Employing a personal health record can decrease healthcare expenses because many of the healthcare dollars go toward the generation of information needed to make diagnoses and provide appropriate treatment. With passage of HR. 3590, which will expand healthcare coverage to an additional 32 million persons by 2019, more patients will be establishing new doctor/patient relationships and the flow of health information will most likely increase significantly.
Although in recent years there has been a push for doctors to purchase and utilize electronic medical record programs for management of patient health data in the hopes that there will be a centralized database of patient health information that will minimize treatment errors, the truth of the matter is, most doctors have not adopted the technology, and even if most did, because of the differences in styles of practice and documentation, a central database would not contain all of the data updated in real-time to meet healthcare needs of every patient in every healthcare setting and situation. Ergo, the best repository of health information is you and your own personal health record.
One scenario illustrating the cost of generating and exchanging health information is the initial new patient visit to establish a doctor/patient relationship. A physician evaluating a patient for during an initial encounter needs information provided by the patient which is oftentimes lacking because the patient is not knowledgeable and/or because previous treatment records were not requested, requested but not received, or requested and received but illegible. The new physician will oftentimes need approximate dates of diagnoses, approximate dates and results of prior tests, and approximate dates of hospitalizations with some details of the care which was given. If that information is not available, some doctors will order tests that he or she might otherwise not order had the necessary information been available at the time of the patient visit. The net result is an increased expense for the patient or at the very least another component of healthcare inflation.
Many diagnostic determinations and treatment courses of action are made based on subjective data, i.e. information communicated by the patient. For example, in evaluating chest pain a doctor will usually need to know when and how the pain started, the location of the pain, the frequency of the pain, the duration of the pain, the intensity of the pain, the quality of the pain (cramping, burning, stinging, etc.), what makes it better, what brings it on, what makes it worse, and other symptoms associated with the pain before deciding whether to admit the patient to the hospital to rule out a heart attack or whether to treat the patient for acid reflux outside of the hospital. Many times however, because patients have not thought about the information in an organized way and/or because of nervousness, patients feel put on the spot when asked certain questions about their symptoms and conditions. By recording information pertaining to symptoms and conditions to be discussed during an impending doctor visit, a patient is better prepared for the visit with useful information which can reduce expenses by minimizing over-reliance on testing. Additionally, the recorded information is likely to be more accurate than information which has not been recorded and thus more likely to maximize the quality of healthcare received.
A personal health record might therefore also reduce healthcare expenses during follow-up visits or sick visits because a well-designed personal health record software program enables the patient to create pre-visit notes and journal notes about new and established problems, which can be printed out and carried to the doctor at the time of a visit. Additionally, the updating of entries in the personal health record by the patient tends to even better prepare the patient to answer questions during an impending doctor visit.
At the time of the writing of this article the duration of an average doctor visit in the United States is approximately 16 minutes which is fairly generous compared to a county like Holland where it is 8 minutes. Factors which are likely to result in a decrease in the duration of doctor visits in the United States include healthcare reform which will increase the number of patients receiving treatment, the shortage of physicians, and increasing medical practice overhead. If the average duration of a visit to the doctor in the United States does shorten the number of visits to address a set number of conditions is likely to increase unless more problems can be addressed during each visit.
Implementing and maintaining a personal health record in principle should reduce healthcare expenses not only at the time of the new patient visit, but also during established patient visits by shifting the diagnostic emphasis from objective date to subjective data and minimizing the number of required visits. The reduction of healthcare expenses by the utilization of a personal health record is predicated on the principle of more efficient generation and exchange of accurate health information.
Disclaimer: This article is for informational purpose only and is not intended to be a substitute for medical consultation with a qualified professional. The author encourages Internet users to be careful when using medical information obtained from the Internet and to consult your healthcare professional if you are unsure about your medical condition.
With more than 20 years experience treating and evaluating patients I understand the importance of accurate patient health information and its contribution to quality healthcare and healthcare cost containment. Learn how to organize your personal health information and how to optimize health information exchange with a personal health record by visiting my website.
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