Healthcare News & Insights

How hospitals are using open notes and mhealth to improve outcomes

Hospitals and physicians struggling to get patients engaged in their health care may want to consider two tools which are seeing positive results — mHealth interventions with care partners and open documentation. 

ThinkstockPhotos-464981841Payors and the feds have pushed engagement as a key component of reducing costs and improving patient outcomes by tying incentives and payments to how well providers can keep patients healthy through self-management.

But engagement is a vague concept, and facilities sometimes have trouble getting patients to heed physicians’ advice about adopting healthier behaviors, taking medication regularly or monitoring symptoms.

However, certain methods, like mobile health (mHealth) programs or giving patients access to their electronic health records (EHRs), are two tactics bringing in good results.

Tech intervention with human help

Recent research has shown that mHealth programs can help patients better manage their own care and symptoms. But a new study suggests to make mHealth even more effective, providers may want to include a patient’s friend or family member as a care partner in the program.

The study, published in the Journal of Medical Internet Research, enrolled 331 patients with heart conditions from the Department of Veterans Affairs health system in a mHealth program. Over a 12-month period, patients received interactive voice response (IVR) calls asking about their health and symptoms, and giving them customized advice for future self-management.

In addition, half of the patients were asked to identify a “care partner” outside of their household, who received emails after each IVR call with reports about the patient’s health and suggestions about how the care partner could support the patient.

In terms of results, both groups had similar outcomes. But there were several differences in how each group handled self-management that the researchers believe show the mHealth program involving partners was more effective.

For example: Patients with care partners were more likely to follow their self-management suggestions, and took their medication more regularly than the control group.

Additionally, patients with partners reported being better able to cope with their conditions. For example, patients with partners were less likely to suffer from depression and other symptoms of decline, such as weight gain or shortness of breath.

This kind of emotional and practical support can be a key part of keeping outcomes positive and keeping patients from being readmitted for more complicated, related issues, researchers noted.

Opening notes to patients

Another way some hospitals are getting patients more involved in managing their care — giving them access to their doctors’ documentation.

As Kaiser Health News reports, more hospitals and providers are allowing patients to see their records with the hopes they will catch errors. But it’s also helped patients better understand their conditions and how to manage their symptoms.

For example, a patient with a potential hand deformity condition knew to monitor certain symptoms by reading over his doctor’s condition summary. Likewise, another patient said he joined the clinical study after reading he was pre-diabetic in the doctor’s notes, a point which was lost under other information during his actual exam.

In other words, opening notes to patients gives them a chance to more thoroughly study their physician’s ideas and recommendations.

Both stories highlight the fact that, although technological advancements give more options for patient engagement to providers, patients may need some real-life guidance from others to use those tools effectively.

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