Media

The following article appeared in the Winter 2007 issue of “Physicians Practice", America's Leading Practice Management Journal which is circulated to more than 276,000 physicians nationwide. The article focused on PatientLink’s participation in a Depression Study with GE Medical Systems throughout the United States.

PUTTING PATIENTS TO WORK: SELF-COLLECTED DATA

A CONVERSATION WITH DEBI CASTILLE, PRESIDENT AND DEVELOPER OF PATIENTLINK

PatientLink is now a series of scannable forms that can be imported directly into a practice's EMR system. Are patients resistant to filling out their health information themselves?

What we've found is that people feel safer and they answer more truthfully. A doctor called me and said, "I can't believe that now my patients are suddenly doing more drugs, or drinking more [since I started using the forms], so I know I must be getting better information!"

This is really important with depression studies, too, because you're not supposed to ask the questions. Patients won't give truthful responses, for a number of different reasons.

Once I followed a nurse as she was preparing a patient to see the physician. The nurse asked the patient, as she was shaking her head no, "You don't do drugs, do you?" So of course the patient is going to say no! People don't want to disappoint you.

During another study at a cardiology clinic, the doctor asked the patient some questions related to her heart condition and she answered that she was fine. As he was leaving the room, though, he gave her a card to fill out. From her answers there, it became apparent that she was not at all fine--she really wasn't doing well. Once the data from the card was scanned in and scored, that prompted him to call her back to get her the treatment she really needed. When he asked her why she hadn't told him how she was feeling, she said, "I didn't want to hurt your feelings!"

How do you ensure that patients understand what's being asked so they do an accurate job of reporting on their symptoms?

On the patient card we put items in patient speak, and we send [the data] to the doctor in doctor speak. For example, "feeling sick" on the patient card translates to "malaise" in the EMR.

Sometimes when we're developing a new card for a practice, the physician will say, "No, I've asked these questions this way for the last 20 years, and this is what I want." So what ends up on the card is what they'd be asking the patient anyway. But we try to translate for the patient, and make sure the patient questions translate to the medical data the doctors want.

Primary care physicians are seeing more and more patients each day and at the same time, reimbursement for that care is going down and overhead costs are going up. What do you say to those who are wary of a technology "patch" for the situation?

I would say that [PatientLink is] technology that meets the need in multiple areas. One is getting complete information from the patient, which can help the physician figure out what's going on. Second, for the doctors it's a solution rather than a patch. Third, it's an inexpensive way to accomplish the first two.

When I go to the doctor, I get nervous--I have no idea why. I think it's because I know I've got five minutes at the most to tell him what's going on. Even if I write things down, I'm still afraid I'll forget things.

Once, I'd forgotten to tell my doctor that I'd been having terrible headaches every day for the past week. When I got home, I had to call in and leave a message for the nurse; she called me back, then she had to talk to the doctor. He looked at the chart, figured out that one of the medications I was on could be causing the headaches, then the nurse had to call me back...

And all of those phone calls could've been eliminated! I'm better when people ask me a specific question than when they just ask what's been bothering me. It helps me to understand what the doctor thinks is important. That to me is not a patch--it's not only better care, it's also a better workflow for the clinic. It saves time not only on data entry, but also on missing information.

What other advice do you have for practices that struggle to handle an ever-increasing volume of data? It seems that we'll never be able to fully realize the promise of new breakthroughs in healthcare research unless we can make smarter, more efficient use of the resources we do have available.

Definitely for things that need to be scored, [PatientLink] is a great solution because not only will people tell you the correct answer, but as the card is scanned, it's scored. For example, with the patient with the heart problem, in the EMR her information can be graphed over time.

Basically, you can target high-risk people and give them a different level of care. Not everyone needs the same level of care.... Some people, especially in older populations, just aren't very verbal. They're not that good at telling others what's wrong.

[Being involved with PatientLink] makes me feel good because I feel like I'm helping patients express their needs to the doctor. And that's so important, especially with depression.- That's something near and dear to my heart because I see the need and I don't see that it's being addressed all that well. I'm very excited that GE is doing this [depression intervention]--I think it's going to help a lot of patients. I'm excited to be a part of it... My mom was disappointed that I didn't become a doctor, so this is my way of helping people get better.