The other day I took my 2006 Toyota Camry for a slightly overdue oil change at the express lube business I go to because, well, it’s convenient – and quick. The lube guys wheeled a computer car-side, and got to work.
I left there 15 to 20 minutes later with an oil change, a new air filter to replace the grimy gray one that was in place – and a three-page “Service Review” document. On the top page is a color-coded graph that shows some of the basic services available – oil change, air filter, injector cleaner, power steering –the recommended mileage for each service and the cost. The other two pages included a service history (blank for now since the garage just converted to the new system) and another much longer list of recommendations for mileage 77, 136 – the mileage on my car that day.
Knowledge is power, isn’t it? I am thrilled with this list. I’m already considering some of the services that, according to the list, are due now. You know, an ounce of prevention…
As I drove away, it occurred to me that when I had an annual physical a few months back, I left empty handed – except for the notes I made to myself to increase my intake of calcium and Vitamin D. I’ve been a patient at the same medium-size multi-specialty practice for years. I’ve seen some changes, but they have come slowly.
A couple of years ago, the practice rolled out an electronic medical record system (eClinicalWorks). My doctor is pro-technology. But, at the beginning she was struggling with finding the screen with the right information. She complained that she couldn’t pull up a couple of screens she wanted and view them side-by-side. She figured she would become more adept that using electronic records and also that the technology itself would improve over time.
As I sat in the waiting room of my practice’s brand new, tastefully appointed headquarters with the flat screen TV offering up the morning newscast, I was asked to fill out a paper form, essentially with the same information I print each time in the little boxes each time I visit. It occurred to me that I could have done that online before the appointment. But online registration is not yet available. Nor is it possible yet to renew prescriptions online or to e-mail my doctor with a question. I still have to call, listen to a detailed message and, as instructed, leave a detailed message.
I think the practice is probably pretty close to meeting most of the proposed meaningful use criteria set forth by the Office of the National Coordinator – and now being reviewed for refinement.
But I did leave the office that day without a summary of my office visit. That would be Objective 19 of the proposed criteria for providers:
“Provide clinical summaries to patients for each office visit. Measure: Clinical summaries provided to patients for at least 80 percent of all office visits.”
I didn’t ask for it, and I didn’t get it.
Shouldn’t patients be afforded at least some of the same tools for preventive care that is provided for care and maintenance of my car? Yes, of course healthcare is more complicated, but all the more reason to bring the best available tools to bear.
The criteria for meaningful use may not be exactly right, and some of them might be burdensome, as many who commented on the proposed rules have pointed out. The ONC and CMS are taking those comments into account now and promised to give serious consideration to making changes to the objectives and measures. But it seems that even those who find fault with some of the specific measures agree that meaningful use of healthcare information technology is an essential part of healthcare reform.
It will give new meaning to healthcare for both the provider and the patient, and it’s been a long time coming.
