Easier to ask about a side dish than side effects

As a physician informaticist who still sees patients part time, I like my patients to be actively involved in making medical and treatment decisions. I find that those patients who ask questions and get involved in decision making tend to be more satisfied with their care. An informed patient tends to be an adherent patient and that’s a win-win situation.

If the Agency for Healthcare Research and Quality (AHRQ) has anything to do with it, this trend toward health consumerism will kick into high gear as a result of an ad campaign it recently launched to encourage consumers to ask questions in their doctor visits. The campaign shows how easy it is to ask a waiter about a side dish compared to asking a physician about a medicine’s side effects, according to an article in the Washington Post last week, and helps consumers learn how to ask the tough questions.

I salute this promotion of health consumerism, or increased patient self-advocacy. It puts a spotlight on the need for more personalized patient visits, and gives the provider valuable input from the patient on their personal health priorities — information that might not come from any other data source.

Wearing my informaticist hat, I embrace the value of personalized information to achieve better quality health care. There is so much individual patient data that can be leveraged for advanced clinical decision support (CDS). Conversely, the recommendations from CDS should be viewed in the context of the patient’s individual health status and health goals.

An example: A patient of mine named Phil has diabetes. Standard rules-based CDS tools have the tendency to treat Phil as “a noncompliant diabetic” because he and I have agreed to check his Hemoglobin A1c every six months due to costs, but the prefabricated alerts label him noncompliant if a test is not performed every three to four months. Phil is a unique individual with unique lifestyle conditions, a unique medical history, unique conditions that influence his adherence to medication therapies and his ability to comply with guidelines, and so on. While all of this information is critical in the diagnosis and treatment of Phil’s health issues, it may be disregarded by clinical decision support that only evaluates a few factors based on historical information.

Advanced real-time CDS tools, however, are able to take in data from a multitude of sources, including information Phil shares with his physician, care manager, or even pharmacist, and deliver updated treatment recommendations in under a second. Comprehensive data sets that incorporate new information at the point of care more accurately define Phil’s individual health status and give more actionable intelligence about to how best treat Phil’s health issues.

The desire for personalized health care is nothing new, but with new advanced clinical data analytics options, that personalized experience can translate into measurably better health care quality.

# # #

J. Matt Yuill, M.D., CPC, is board certified in internal medicine and pediatrics, and earned his doctor of medicine degree from the University of Kentucky College of Medicine in 2000. Dr. Yuill is also the founder of the HCC Blog and is a nationally recognized expert on Medicare Advantage risk adjustment. Dr. Yuill is a certified professional coder, and joined Anvita Health as a physician informaticist in 2008.