Advances in health care information management and communication were one theme of the 10th annual Grandon Lecture, delivered May 10th by Arthur "Abbie" Liebowitz, MD, FAAP, Executive Vice President for Digital Health Strategy and Business Development, Medscape Inc. In his talk, entitled "E-Commerce: What is Ahead for Healthcare?", he predicted a day when electronic medical records would be the norm, and patients would "own" their own records.Some experiments are already under way to test online patient access to health records and the use of electronic communication between patients and care managers. For example, the Palo Alto Medical Foundation (PAMF) has been testing "e-health" services with a small group of patients since December 2000.
According to the PAMF's newsletter, patients receive a special password to protect their privacy. Then they may access their diagnoses, medication lists, allergy lists, immunization histories and health maintenance schedules. They may also request prescription refills or appointments online, or send questions via email to members of their health care teams. Such services are possible because PAMF introduced an electronic medical record (EMR) system in 1999.
TJU's own Dr. David Nash, Associate Dean of Jefferson Medical College and Director, Office of Health Policy & Clinical Outcomes, serves on a scientific advisory board for a pilot program in Minnesota. According to a recent article in The Scientist, Winona Health Online started with 200 patients last year but is now opening up for general participation. Patients receive personal passwords and a personal Web page. After screening by a physician, lab results and diagnoses are available for patients to view. Like the PAMF model, patients may request appointments and prescription refills or send secure emails to their health care providers. Email in this system is based on templates, to better organize the topics. The Winona model is also made possible by an EMR system.
Experiments such as these point out many areas of concern to both patients and physicians - privacy issues, quality of treatment, filtering of information, cost of services, uniform access to services, and satisfaction for both patient and clinician, to name just a few. Awareness of such concerns is one reason for the advisory board on which Dr. Nash participates; careful scientific evaluation over five years is part of the plan for the Winona project.
Dr. Liebowitz's lecture demonstrated the need for Jeffersonians to be aware of and participate in ongoing developments in this field, in order to influence their direction and our future.
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