Dr. Kevin Most: Medical Records and Spring Allergies
Remember when you would go to the doctor and have blood tests and he said, “if you don’t hear from me everything is good” ? Or how much anxiety did patients have waiting for the results of a test or x-ray as they waited for days for the doctor’s office to call with the results. Well for one that is not a great way to practice medicine and how often did you leave concerned that the lack of a call may have been due to a missed report or a really busy nurse or doctor’s oversight.
With the Electronic Medical record much of that has changed. Doctors initially went kicking and screaming in some cases as they were forced to go to an electronic record getting away from a paper record. This has allowed us to deliver safer care and has also allowed us to share information with other doctors, hospitals and more importantly the patient. Almost every doctor is now on an electronic record, The federal government has really forced all doctors to the electronic record.
Has it caused some dissatisfaction among doctors? Sure especially for doctors later in their careers. Many feel it has decreased the time we spend with patients while at the same time making our days longer to complete our charts. We hear complaints all the time from the patient who says “the doctor had his back to me and was typing in the computer the entire time” Believe me, Doctors don’t want to have their back to you, they want to be able to sit with you, spend time with you during the visit but the advancing age of technology has impacted this. In the paper world many docs had templates and could hold the chart in their hand and complete their charting while looking at you, they would pull out their prescription pad and write your prescriptions. They would then leave the room and go on to the next room.
Fast forward to now, doctors are forced to type their records with some templates electronically, we prescribe thru the computer and often have additional charting that needs to be done after leaving the room. So many feel the patient experience has been diluted.
Have we improved care? In some ways Yes, The computer actually looks for drug interactions which are increasing as the number of medications increases. It allows us to often view the reports of specialists on line in the record. Before the EMR we would have to wait for the typed letter to come to our office and hopefully find its way into your chart. It allows us to keep an accurate list of your medications and allergies. So in many ways it is much better.
The next step beyond the Electronic Record has been the patients access to their record via computer or even on their cell phone. If you as a patient do not have this, ask your doctor or their staff next time you are in the office. Many call this access “my Chart”, as you have to realize that all the information we have in the medical record actually belongs to you. It is your record. Hopefully many of you already have this on your phone or computer.
This access has some great functionality, it often allows you to make an appointment. The old days of calling the office and being placed on hold will soon be obsolete. The patient will go on line and either make an appointment or request an appointment. Better yet the office will send you a message via this application to remind you to schedule your appointment. Many of the applications have something similar to “open table” where you can choose an appointment.
It also allows you to update your medication list so the doctor will know when you changed a medication.
Another fascinating thing they are doing with Artificial Intelligence and the medical record is the ability to review a lot of data quickly. This has allowed for researchers to predict illnesses in some patients. Last week a study came out showing the ability to predict suicide attempts 2 years in advance. The research looked at the EMR for 2 million Tennessee patients, 3,200 of them had attempted suicide. Researchers used machine learning, reviewing the medical histories and other risk factors and came up with the combination that could predict future suicide attempts. It is studies like these that show the power of data and computers.
One of the other great things is it allows you access to your test results, some systems set this up so your results are released to your chart after they have been reviewed by a doctor. Other systems allow for the results to be released to you as soon as they are available. This has changed the way doctors practice now, often they will discuss the blood test before you have it and explain what results he is expecting and what they mean. This allows you some education prior to seeing the results so you are not confused by the results. For abnormal test results the expectation should still be some active communication between you and the office staff.
While all of this is great, the concern for cybersecurity breeches cannot be minimized. Protecting the personal health information for patients is a top priority for all health systems. Hackers are continually trying to breech hospitals and health systems and each employee goes thru cybersecurity training. Protecting your records is very important.
What a strange winter it has been. Playing golf in February in shirt sleeves should not be happening north of the Mason Dixon line yet a few weekends in the past month has allowed just that. Are we confused? Yes and not only us, mother nature is as well. You may be noting flowers peeking thru the ground, well before we expect them. Trees are budding and pollen counts are creeping up. Couple that with the continued outlook for warm weather and we may have not only a big allergy season but also an early allergy season.
Is there anything to do? Well as we have discussed earlier getting ahead of allergies is the key and the timing of the this is a bit more difficult this year. Who would think we would be talking about tree pollen in late February and early march. That season is usually late March and into April and in some years pushed back to late April.
So what can we do, well if you know what you are allergic to, check the pollen counts. These are usually available on most weather apps or on line. If you don’t know what you are allergic to but know you have spring allergies, start to monitor symptoms. One good thing is that most of the allergy medications are now available over the counter so getting started on your medications should be timely and often will not require the appointment to the physician.
So watch for your allergy symptoms to start to trigger, runny nose, itchy eyes, congestion, all signs of spring allergies. If you note them, get started on your antihistamine and nasal spray to keep the symptoms under control.