I got two pieces of related information yesterday.
A connection to your doctor and your data, Group Health iPhone app
Second, a tip from my colleague Paulanne Balch, MD (@BPBMD2) about the article “Is Patient-Centered Care the Same As Person-Focused Care,” written by Barbara Starfield, MD, MPH, published in this quarter’s The Permanente Journal..
The two are very related. Notice how the press release from Group Health begins (hint, it doesn’t start with a discussion of technology):
FOR IMMEDIATE RELEASE:
Monday, Aug. 22, 2011
Katie McCarthy, 206-448-2149
Patients can email doctor with new Group Health mobile app – iPhone version available now, Android launches fall 2011
SEATTLEâ€” Group Health members can now email their doctors while on the bus, make an appointment with a doctor while waiting in line for a latte, and even check on the wait time at the closest Group Health Lab and Pharmacy. With the new Group Health mobile app, Group Health offers its members a first-of-its-kind free mobile app with convenient access to their personal health and medical team.
â€œGroup Health pioneered access to online medical records and ability to email doctors more than nine years ago,â€ said Gwen Oâ€™Keefe, MD, chief medical informatics officer for Group Health. â€œToday, when most health care systems are adopting electronic medical records, weâ€™re able to take the tools our members have come to know and love on MyGroupHealth, and move them to the mobile environment so members have the freedom to engage when, where, and how they want.â€
Now, what Barbara Starfield, MD, MPH (rest in peace), an acknowledged world expert on primary care and population health writes about ‘person-centered versus patient-centered’:
The essence of person focus implies a time focus rather than a visit focus. It extends beyond communication because much of it relies on knowledge of the patient (and of the patient population) that accrues over time and is not specific to disease-oriented episodes.
Barbara goes on to complain that many innovations in primary care rely too much on disease diagnoses and professionally defined problems, rather than patient defined ones – she says, “Care is better when it recognizes what patients’ problems are rather than what the diagnosis is.” and makes this remark about patient portals and virtual visits:
They will be useful only to the extent that people are confident in their cliniciansâ€™ accumulated knowledge of their problems. Yee argued that the functioning of new primary care organizations must â€œinclude innovative forms of interactions that do not depend on traditional office visits.â€
And so here we have an application of mobile technology that is not directed at patients managing diseases or tracking clinical endpoints, it’s directed at physicians knowing their patients better over time, which is what primary care is supposed to be anyway.
I asked Colby Vorhees (@colbyv) about what the experience has been with the app so far, and here’s what he said:
Regarding messaging and access – we’re averaging about 200 sent messages/week via mobile (6,200 downloads from the app store). We average over 9,000 week via the website, so with barely 2% of normal traffic it’s tough to tell if there’s a significant add in messaging (as opposed to a shift from web to mobile). Overall, the top five features (in order) are:
* wait times
* secure messaging
* lab results
* symptom checker
* upcoming appointments
Group Health Research Institute is going to be looking at mobile and web use, and what the shift (if any) is in our population.
In the Starfield article, she even points out Group Health as a welcome exception to her concern that The Patient-Centered Medical Home is too much about doctor visits and disease management:
Reid and colleagues [Group Health Research Institute] and Gilfillan and colleagues36 evaluated interventions consisting of elements such as secure e-mail interactions between patients and health care professionals, disease registries, care planning, self-management strategies, increased outreach to patients, team discussions, performance evaluation, practice teams, population profiling, home health, and designated specialists in settings where there was excellent primary care and included all patients (not just those with selected chronic diseases).
This is what you get when you start with a person focus, an innovative medical group, a member-governed health care system, and add technology to it, rather than doing it the other way around.
As I have mentioned several times on this blog, my community colleague Susannah Fox (@susannahfox) shows again and again in her research that the #1 place people want to get health information from is a health care professional/their doctor. It is unsurprising, then, that the technologies that deliver this experience fantastic adoption.
Take a look, enjoy, and feel free to chat the Group Health team up on twitter to learn more, either at @GroupHealth or via Gwendolyn O’Keefe, MD (@GwendolynOKeefe) or Colby Voorhees (@ColbyV). They want to tell this story so that one day the rest of health care will tell it, too.