Patient Knowledge and Experience is the largest untapped resource in healthcare

2018-0529PracticeBasedEvidenceCTLdream

Yes, I firmly believe this. We are starting to mine our EHR data. We can begin to see prescribing patterns, and how they affect patient vital signs (blood pressures, heart rates, pulse ox). We can look at aspirin prescriptions in patients with coronary disease. We can look at steroid inhaler prescriptions in patients with persistent asthma.

But what about patient experience? Those who have conducted Group Visits can begin to see patients educating each other, in ways that physicians, staff, educators don’t understand. “How do you manage your insulin dose when you work swing shifts or night shifts?” “When you catch yet another cold, how does that affect your liquids intake and medications for heart failure?”

Companies like “PatientsLikeMe” are beginning to look at this information as well. It is about time that our EHR vendors (or maybe startup companies) start helping us unlock the knowledge inside our own medical records for the benefit of other patients.

FOR EXAMPLE, in the screenshot above, in a presentation that I give, consider a 55 year old man with worsening knee arthritis. How hard would it be for us to find “patients like me” treated in the past few years with similar symptoms, similar age/sex/activity level/health status, who were faced with a similar decision about choosing an orthopedic operation and physical therapy?

We could say several really interesting things:
-See how many chose each option
-Compare the 3, 6 and 12 month outcomes of each choice, for pain and function
-Evaluate PROMIS (patient reported outcomes) of each option for: overall health, anxiety, depression, functional status.

Who would NOT want such information? Local, recent experience of other people like me, facing a similar challenging decision.

CMIO’s take? Time to disrupt ourselves.

Author: CT Lin

CMIO, University of Colorado Health; Professor, University of Colorado School of Medicine

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