Tag Archives: secure messaging

VA eHealth University Charts Future – More Shared Information with Patients

It was an exciting week for attendees of the VA’s eHealth University in Las Vegas. “VeHU“, as it’s called, is an unparalleled chance for VA professionals to rally around electronic records – with demonstrations, hands-on training, deep dives and up-to-date talks.

Transforming care delivery was a theme, with informatics solutions all around. I joined a panel on use of health IT for Patient-Centered Medical Home. I talked about patient-facing information and Participatory Care. My portion of the session’s slides:

I also participated on 3 classes on secure messaging. We focused on improved patient access, efficiencies in communicating online (for patients and professionals alike), and how messages between visits lets providers know more about patients. I’ve talked before here how messages bring more context and an emotional connection..

Speaking of connections, VeHU planners hit it out of the park for the closing plenary. Stories, videos and a performance by the 4 Troops, a young veteran quartet with lovely voices and beautiful songs. Transformation can happen when people make emotional connections. How can we do this on a regular basis, not just at a once per year conference??

The Paradox of Asynchronous Patient-Clinician Communication

It’s been busy in VA informatics, as many of us prepare for VA eHealth University (and why my posts are few). Known as VeHU, this well-attended conference is packed with health IT workshops, tips, overviews and more. It started as “Camp CPRS”, stemming from the need for developers, clinicians, leaders and educators to come together on the electronic record. I’ve been once, early in my consumer informatics career, and was thrilled to see and hear so much. Amazingly, I can hardly wait to get to Nevada in August!

I’m faculty for several sessions focused on Secure Messaging. Online communication between patients and providers is now used in a limited number of sites, with plans underway for expanded adoption. E-messaging is a key service for Patient Centered Medical Home, which I’ve talked about here and here.

I’m privileged to collaborate with a primary care doc from Anchorage and Veteran patient on a session titled, ‘Hit the Jackpot with Secure Messaging’ (hey, it’s in Las Vegas). We’re doing a deep dive about message content and value. I’ll share a taxonomy of several hundred messages and show examples. In studying messages, I’ve learned a great deal about how secure email is used and its power. I also learned about an interesting paradox.

Many clinicians envision that using online communication with patients is impersonal (like regular email can be), it is actually personal and profound.

Patients write in ways that add much dimension to their care. People suffering from chronic problems express gratitude. Depressed patients share what supports them at home. Those juggling care by multiple specialties give information that helps coordinate their care. I’ve received patient reminders of things we discussed but that did not happen (I’m not perfect). And thank-you’s come in numbers that warm any health professional’s heart.

We’ve entered a new era of communication in healthcare. Patients are the #1 under-utilized member of the team, and secure email proves it. Now that’s meaningful use.

These are not new insights. e-Patient Dave and others talk about this But greater understanding of this paradox is needed if we want secure email to become standard of care.

Blogging, Like Emailing Patients, Needs to Fit into the Workflow.

First, thanks to Ted Eytan for his nod here to my entry into the blogosphere. Thanks Ted!

Blogging is a lot like online secure messaging with patients. I want to do it, but it’s hard to fit into my workflow. It should fit and must fit, but there’s some design challenges. As a result, I don’t get “credit” for it. Let me explain.

I’m putting together my dossier for an academic promotion. My work has to fit onto 1 of 3 categories: (a) research and scholarly work, (b) service to programs or curricula, or (c) clinical care. Social networking with leaders and thinkers in a field need not apply. So my time studying and writing online can’t contribute to my academic persona. Now I wonder…maybe I should leave it off my vitae entirely…

What does this have to do with communicating online with my patients? Well, clinicians don’t really get credit for this non-face-to-face type of care delivery. Most clinicians – even those who want to e-message, find that it doesn’t fit into the current structure of care built around in-person visits. In their paper, Initial Experience with Patient-Clinician Secure Messaging at a VA Medical Center, Byrne and colleagues found that in systems where reimbursement does not drive clinician performance, it’s challenging to fit e-messaging into a clinician’s day.

Will health care find simple ways to integrate virtual communication into the workflow AND the workload? What will it take?

I think when patients start voting with their feet, choosing clinicians and practices that use secure email over those who don’t, the design of care delivery will change. – S.Woods

To be honest, I’m more optimistic about getting credit for messaging patients than having the Promotion & Tenure committee finding any value in my blog 🙂