Patient engagement was a major theme of the Partners Connected Health Symposium, and that theme came to a head Thursday with a talk from Epic President Carl Dvorak, who contends that for electronic health records like Epic, engagement with the patients is "the last mile," the home stretch EHR vendors are currently embarking on.
Everything Epic does to innovate, Dvorak said, he assumes will soon become standard for EHR systems, just like car stereos were once a feature you had to purchase separately and now are just assumed to be part of a new car.
"Today's leaves become tomorrow's branches," he said.
Dvorak talked about a number of patient engagement tools that are already available through Epic and its MyChart patient-facing app, but also previewed some new pieces the company is working on.
Scheduling appointments, for instance, is a key functionality for a patient-interfacing EHR. But beyond just allowing a patient to schedule a visit, Dvorak wants to use the power of mobile to offer wait-listed patients quicker appointments if one opens up, as a push notification on the patient's app.
Another point Dvorak stressed was communicating with the patient in a variety of ways, whether that means offering multiple languages or offering multiple contact points. At Epic, he said, they are integrating the contact methods so patients can flow seamlessly from one into another.
"We can step up a text to an interactive chat, and if it seems significant we can move it into a phone call, or a video visit, or bring them in," he said.
An early pilot of video visits via MyChart started a few weeks ago at Stanford, Dvorak said.
Dvorak talked about data analytics in the back end of the EHR, not just to help doctors with population management, but also to help patients with the choices they have to make about their own care.
In a system Dvorak demoed, a patient could track the outcomes from a treatment decision against historical results from other patients.
"So if I see I'm behind other people who made this choice, maybe I should have made a different choice," he said.
One seldom-discussed avenue for interoperability is connecting patient EHRs to other patients' EHRs in the system. Dvorak said that when patients are asked to complete a medical history, studies have shown they are 50 to 60 percent accurate about their parents' health and only 20 to 30 percent accurate about their grandparents.
But as EHRs become more established, most patients' parents and grandparents have medical records of their own. Epic is working on a system where families can opt in to share their medical history with one another in order to give children a more complete picture of their genetic disease background.
Finally, Dvorak spoke about the perennial hot topic with EHRs -- integration. He said the company is working on new ways to make the EHR as open as possible while still being safe and secure.
As new payment models take hold, Dvorak said, accountable care won't just mean holding doctors accountable for patient care, but also keeping patients accountable to their responsibilities in their own care. And that can be done by building as much engagement as possible into the EHR system.
"The biggest thing that needs to change is accountability for the patients," he said. "We have to find a way to engage patients at a deeper level. And this is especially important when you're at risk financially for that patient."
