The Power of a Chart

 

Recently I got a pointed reminder about the value of an electronic health record. My own physician—who was reviewing me for my annual physical—still uses a paper record. Electronic prescribing? Forget about it. But he’s a great diagnostician. That’s why both my wife and I have stuck with him for well over a decade. He’s kind of a rare bird internist who can tackle the most mundane clinical chores with gusto (not to be gross, but removing ear wax would not be my first choice of tasks). He’s our PCP, and while on occasion we have to go to the specialist, we relish our time spent with him.

But during my visit, he had to flip through a growing stack of papers to see the dates of former tests and the measures of various historical vital signs, like blood pressure. When we were talking, I thought: wouldn’t it be great if he could pull up a screen and see a chart of these critical clinical values over time? He could see the peaks and troughs that reveal our health. Now I am fortunate, in that I am fairly healthy and have managed to sidestep serious health issues. It’s probably one reason my doc is glad to see me. Compared to many of his patients, I’m probably a model citizen.

In all fairness, I’m one of many people who have yet to adopt a PHR and keep track of such things myself. And I know I should. After all, it’s up to me to stay healthy and avoid the unnecessary health risks. But I’ve spoken with any number of physicians who have adopted ambulatory EHRs, and really appreciate the graphing capabilities of the technology. Systems commonly accept lab scores as direct data feeds of discrete information, and even manually entered data, such as blood pressure scores or weight, can easily be plotted. When patients can see objective information about themselves, and see it on a trend line, my hunch is they will sit up and take notice—especially if it is a measure over which they can exert control.

I just filed a forthcoming article on chronic disease management. Conditions like diabetes and obesity beg for patient involvement and compliance. And the innovators are using their software to encourage both, by pushing out test results and other data directly to the patient, or in turn, letting their patients send data directly to them electronically. Granted, there are many patients who undoubtedly have “given up” on their own health. For them, no amount of I.T. interfaces could make a difference. But I think many of us want to be and stay healthy, and having easy access to our data is a good tool. Its utility is only enforced when our physicians are on the same technological page.