Throwing out old files from my office recently, I came across this blast from the past. In effect: “we should include an e-mail or electronic message function in the Electronic Health Record” or at least, “could you allow us to use our email program on the same computer as our electronic medical record? Then we could possibly cut and paste important questions and conversations between providers and cut down on full consults and referrals and improve coordination of care”
In 1997. At least 3 EHR implementations ago.
I hate to say “I told you so, but … I told you so.”
Here we are in 2020, and we have since studied patients having online portals and using online communication with providers and found these tools to be practical for providers and nurses and patients, and also shown to improve adherence to treatment and high satisfaction.
We have implemented Project CORE, a method for docs to request electronic consults from specialists on their patients; straightforward questions that come up regularly can be quickly and easily answered by colleagues WITHOUT having the patient physically go see the specialist. It is a win-win-win (speed of response for referring doc, no extra effort for patient, easy question/answer by specialist and decompressing packed schedules to make availability for more complex patients). Almost all our specialties now offer this to our primary care colleagues.
We have implemented Secure Chat within our EHR, an ability not only to send email-like messages (have had that since we implemented in 2011), but to send near-real-time text-like messages, securely within the mobile app (Haiku) associated with our EHR (Epic). Here’s an article from Providence Health System in Portland describing the features. Such interruptive alerting can be intrusive, but also when used well, can power highly-functioning teams.
- Email in 1997, at the time of this document, was a “new thing”. In fact, connecting computers to a “network” directly into the wall-jack was a new thing. I had purchased several generations of modems for home, where I could connect by phone line to the “Internet”. Of course, we WOULD NOT put patient charts on the computer, right? That’s just a ridiculous idea.
- Mobile phones in 1997 were increasingly common, but the number pads were a TERRIBLE way to type an SMS message. It would not be until the Blackberry in 1999 showed us that a ‘chicklet keyboard’ was a faster way to type what later became instant messages.
- And now, both of these communications technologies are embedded in EHR’s.
This reminds me of something someone said to me when she was 5:
“That was back in the days of the dinosaurs, when you were alive, but I wasn’t.”
–baby daughter Lin, age 5
CMIO’s take? 1997 to 2023: electronic messaging in EHR’s? I told you so. I was just 25 years too early.