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« New Pew Data on How People with Special Needs Use the Internet

Information Maze vs. Information Therapy »

Small Practice, big ideasI spent my last day in New York shadowing in one of Institute for Family Health’s smallestpractices - two physicians and a nurse practitioner. Like the other practices in the system,this one is busy, taking scheduled patients and walk-ins. And like the others, it is fullyenabled using an electronic health record. Pictures are below. Click on any to see full size.

I saw the art of family medicine here, which is that regardless of the time pressures alwaysfaced in medicine, physicians are able to focus and be there for their patients. The physicianI saw practice on this day had a really nice rapport with her patients and I noticed was ableto connect with them on topics important to them outside of health care - trips they might betaking, or significant family issues. This is always great to see in the context of anelectronically enabled practice - doctors can still be doctors. The other significant thing for mewas the kindness of the patients in their willingness to let me learn about their relationshipwith their doctor by watching the interaction. The several that I observed were welcomingafter an informed consent was obtained by their physician.

Also, a new best practice for me (I think) - sitting while shadowing. I have traditionally stoodin a corner to be as unobtrusive as possible, but it was brought to my attention that my heightmay be a little imposing in the exam room. I liked it - more at the level of the patient, andmore blended in. With great thanks to the 13th street practice.

What about the PHR? I was informed that this practice is diligent about sending patientsresults and other important health information, which made me think about the value of apersonal health record here. What if patients could retrieve their own information,accompanied by information about each test automatically (Information Therapy)? It wasimportant for me to come visit and see that reality for this practice. I think there could be winhere in physicians empowering patients to become informed about their own care on theirown time. One issue this system will face is in their use of external ancillaries, such as laband radiology. The PHR may force the issue of establishing a solid interface to both, and thisis a good thing - the patients will expect their data to be available to them and to theirprovider. Everyone wins.

Later in the day, I met with Karen Nelson, MD, MPH, the CEO of Unite HERE HealthCenter. The facility is beautiful and modern (see pictures below), and also fully electronic,using the General Electric Centricity Product.

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Major U.S. payers supportPatient-Centered PrimaryCare CollaborativePicking up steam - a way tosupport these activities in everyday practice

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Turnstyle to the Future.... EHR Training Room, Washington

The Safety Net and Health Information Technology

• Uninsured does not mean Uninformed (Deloitte, 2008)

• Many getting EHRs with no patient access

• Marginal data on EHR penetration

• Poor data on patient access

• Awareness about Internet use is low

• Emerging workforce issues related to HIT adoption

• Visit-based reimbursement creates challenging incentives

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Use of the Internet to Communicate withHealth Care Providers in the United States:Estimates from the 2003 and 2005 HealthInformation National Trends Surveys(HINTS)

Ellen Burke Beckjord1,2, PhD, MPH; Lila J Finney Rutten2, PHD, MPH; Linda

Squiers3, PhD; Neeraj K Arora4, PhD; Lindsey Volckmann2, BA; Richard P

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Original Paper

Exploring Social Contextual Correlates ofComputer Ownership and Frequency ofUse Among Urban, Low-Income, PublicHousing Adult Residents

Lorna H McNeill1, PhD, MPH; Elaine Puleo2, PhD; Gary G Bennett3; Karen M

Emmons3

1Department of Health Disparities Research, The University of Texas MD

Anderson Cancer Center, Houston, TX, USA

Supply and Demand 2008 Deloitte survey of consumers in health care

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