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Health-care providers, patients are communicating online

  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professional.<br/>KEVIN GUTTING

    Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professional.
    KEVIN GUTTING Purchase photo reprints »

  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy digital telemonitoring unit daily to communicate his vital signs to his health care team at the VA Hospital in Leeds.<br/>KEVIN GUTTING

    Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy digital telemonitoring unit daily to communicate his vital signs to his health care team at the VA Hospital in Leeds.
    KEVIN GUTTING Purchase photo reprints »

  • Navy veteran George Murphy of Holyoke, 73, checks his blood pressure and types the results into his Health Buddy telemonitoring unit, which transmits the information to his health team at the VA Medical Center in Leeds.<br/>KEVIN GUTTING

    Navy veteran George Murphy of Holyoke, 73, checks his blood pressure and types the results into his Health Buddy telemonitoring unit, which transmits the information to his health team at the VA Medical Center in Leeds.
    KEVIN GUTTING Purchase photo reprints »

  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professionals at the VA Medical Center in Leeds.<br/>KEVIN GUTTING

    Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professionals at the VA Medical Center in Leeds.
    KEVIN GUTTING Purchase photo reprints »

  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professional.<br/>KEVIN GUTTING

    Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professional.
    KEVIN GUTTING Purchase photo reprints »

  • Army veteran Mark Ellis of Springfield uses My Healthevet to track his medications.<br/>KEVIN GUTTING

    Army veteran Mark Ellis of Springfield uses My Healthevet to track his medications.
    KEVIN GUTTING Purchase photo reprints »

  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professional.<br/>KEVIN GUTTING
  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy digital telemonitoring unit daily to communicate his vital signs to his health care team at the VA Hospital in Leeds.<br/>KEVIN GUTTING
  • Navy veteran George Murphy of Holyoke, 73, checks his blood pressure and types the results into his Health Buddy telemonitoring unit, which transmits the information to his health team at the VA Medical Center in Leeds.<br/>KEVIN GUTTING
  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professionals at the VA Medical Center in Leeds.<br/>KEVIN GUTTING
  • Navy veteran George Murphy of Holyoke, who turns 74 next month, uses a Health Buddy telemonitoring unit daily to communicate his vital signs to his health care professional.<br/>KEVIN GUTTING
  • Army veteran Mark Ellis of Springfield uses My Healthevet to track his medications.<br/>KEVIN GUTTING

Instead of picking up the phone, she uses her iPad to log onto the center’s website and link to a password-protected “patient portal” where she can send email to her physician, review test results or request an appointment.

As the system expands in the near future, the patient will be able to fill out medical histories and other forms online, schedule an appointment similar to the way she would book an airplane flight, and have text-message reminders about flu shots and annual exams sent to her cell phone.

“There’s also a really nice education piece to this,” said Martha Mastroberti, manager of health-care informatics for Valley Medical, as she clicked onto another link in the portal. “We have a symptom identifier, a checklist to help people decide when they need to call a doctor.”

The portal — which Valley Medical launched three years ago for the 60,000 patients served by its Amherst, Greenfield, Easthampton and Northampton centers — is the most commonplace sign of how digital communications technology is changing the delivery of health care in the region.

Over the past year, other area health-care providers have begun using secure online sites to streamline communications with patients with the goal of improving care.

Experts say such “wireless medicine” is on the rise nationwide, from virtual office visits to new digital monitoring tools for patients with chronic diseases, to the use of social networking sites for health education.

“We’re now seeing doctors demanding iPads instead of clipboards and there is starting to be a platform for more and more clinical applications,” said Christopher Larkin, a University of Massachusetts Amherst alumnus who is chief technology officer for GE Healthcare’s hospital division in Seattle.

Online communications “are what you and I have come to expect as consumers,” added Larkin, whose global company produces medical information technologies and patient monitoring systems. “The things we’ve been doing in business for the last decade are now happening in health care.”

Health-care providers say a key driver of the digital trend is a federal push for electronic medical records. The Obama Administration’s Recovery and Reinvestment Act of 2009 included $17.6 billion to support conversion to electronic health records.

Under the Affordable Care Act signed into law in 2010, the federal Medicare program expects to spend nearly $7 billion over five years in incentives to doctors and hospitals that can show they are using electronic records to reduce costs and improve care.

Portal technology

Valley Medical Group, where 40 percent of patients are now active portal users, has received incentives worth $44,000 per physician, according to its President Joel A. Feinman.

Still, he says, incentives and cost savings are “way down the list” of reasons the practice chose to become an early adopter of portal technology.

“Though it does reduce costs, I’d say it’s more about giving patients access to their health information,” Feinman said. “It’s about convenience for both the patient and provider. And it’s safer now than online banking.”

Dr. Peter Kenny of Northampton Area Pediatrics said a portal launched six months ago for patients at its Amherst and Northampton sites is changing doctor/patient dynamics in “exciting and positive ways.”

Kenny, who has been practicing medicine since 1976, added, “It’s a tool that at the simplest level, allows the patient to communicate more directly” without having to be on the same schedule as the doctor. That can be especially important for parents of children with chronic illnesses who need frequent care and advice, he said.

Providing patients easier access to information about their health may also encourage them to be more involved in making decisions about their own treatment, Kenny said.

“In the context of larger changes in medical care, this makes our care more patient-centered,“ he said. “Technology is making that possible in ways that weren’t possible before.”

National studies project that the proportion of family physicians using electronic records — the source of data for the portals — is expected to grow from 37 percent five years ago to 80 percent by the end of this year.

Dr. Lawrence Garber, a member of the state Medical Society’s Information Technology Committee, said many doctors who were initially reluctant to use new communications tools are now seeking them out.

“The concerns from the physicians’ side that we would be getting too many email messages that would take up more of our time haven’t been realized,” said Garber, an internist who is the medical director for informatics at Reliant Medical Group in Worcester. “The messages we have been getting actually help us accomplish things.”

He believes providing patients more and faster access to their health records will ultimately help boost safety and quality of care. “If we send patients lab results through a portal, in the rare chance I miss something, I now have a second set of eyes,” Garber said.

Mark Ellis, a U.S. Army veteran who volunteers at the VA Medical Center in Leeds, said the online “My HealtheVet” portal he signed up for three years ago has been “a big help” in keeping track of appointments and medications he takes for high blood pressure and other ailments. “It’s actually helped me have conversations with my doctors,” said the 55-year-old Springfield resident, who served in the Army during Desert Storm. “I had an adverse reaction to a medication awhile ago and my doctor called me right back about 20 minutes after I sent him an email” through the portal.

Contrary to expectations that younger people are the ones most likely to log on to portals or check cell phones for text messages from their doctors, Mastroberti of Valley Medical Group said patients 60 and older are the practice’s most frequent portal users. That is partly because they are also the biggest consumers of health services, she said.

Others say digital communications are part of a broader shift toward more coordinated, patient-directed care.

“The whole purpose of going to technology is to engage the patient in their care,” said Denise Scott, director of quality and informatics for Cooley-Dickinson Practice Associates.

Cooley Dickinson Hospital, which recently affiliated with Massachusetts General Hospital in Boston, is still working on a portal system, Scott said. Future plans include “telehealth” visits, where doctors can consult with patients via wireless connections.

Setting up online portals that work for hospitals is a challenge, Scott said, noting that, “vendors haven’t created a hospital-wide system.”

The way hospitals are reimbursed for care is also a factor in how technology is used, Scott said.

“If you are communicating with patients electronically, at some point you will be doing medical decision-making,” she said. “That’s equal to an office visit. But care provided electronically is not always reimbursed.”

Other challenges include privacy issues, such as how to allow family members access to electronic records of elderly patients or teens who may not want parents to see all of their health information.

While new communications tools are promising, they cannot fully replace face-to-face contact between doctors and patients, said Kenny.

To ensure that computer screens don’t become a barrier, his practice hires “scribes” who accompany doctors into exam rooms to type information into health records while doctors talk with patients.

“Making an investment in technology so it’s used properly is what’s important,” Kenny said. “We’ve worked hard to have technology that doesn’t get in the way.”

Related

VA Healthcare System a leader in wireless medicine

Wednesday, February 13, 2013

NORTHAMPTON — The VA Healthcare System went digital back in the 1980s, two decades before many private health providers began using electronic medical records. As a result, VA administrators say, the system has been an early laboratory for the use of new wireless communications tools such as online patient portals, portable devices to track patients with chronic diseases and “telehealth” …

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