Monday, December 9, 2013

I very much enjoy the "contrarian, brainy and literature-based resource by Jaan Sidorov" over at The Disease Management Care Blog.  A recent post provides an example of how he makes us think. The lede:

In the November 19 issue of the Annals of Internal Medicine, Caroline Lubick Goldzweig and colleagues examined the published science on the purported advantages of electronic health record (EHR) portals.

Recall that portals are web-based entryways that on-line health consumers can reportedly use to access their records, request medications, correspond with their doctors, manage their health conditions, reduce health care costs, increase U.S. life expectancy, reduce our national dependency on jumbo-sized sugary drinks and fix everything else that ails the U.S. health system.

Unfortunately, facts have intruded.  After looking at fourteen randomized prospective trials, 21 observational, hypothesis-testing studies, five descriptive studies and six qualitative studies, the authors concluded...

 "...evidence that patient portals improve health outcomes, cost, or utilization is insufficient."


Of course, Jaan cleverly makes us notice by creating the straw man and then knocking it down.

I, for one, never believed that patient portals would do much with regard to outcomes, cost, or utilization--although, as e-Patient Dave has pointed out, sometimes patients notice mistakes in their records and thereby avoid harm.

No, the main advantage I see is one of convenience, and once you have experienced that, it's hard to go back to the old way.  But the convenience is not made universally available.  In my health care system, for example, some doctors permit appointments to be made and changed electronically, and some do not.  One of my best doctors has still not caught on to the fact that his refusal to play makes life harder for his patients and his staff and, ultimately, himself.


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