“Doctor Nieder, my wife got this new smartphone and she wants to know why she can’t communicate with you using it. Can she?” This coming from a 70 something patient. I’d seen his wife a few days previously and she had a question about her medication. She wanted to know why she couldn’t just email me about it.
We talked a little bit about the insecurity of email and personal health information (PHI in my world). Then I happily explained that, indeed she could communicate directly with me using her smartphone. I gave him my card with the RelayHealth information on it, directed him to look to the upper right-hand corner of the website and click “register”. This will take her to this page:
After finishing the registration process, pick a provider – me – and then RelayHealth sends me notification of the registration. After that she can directly communicate with me. He left the office happy to have good news for his wife.
I know many of my colleagues are hesitant to give patients direct access but consistently the portal has saved me more time than cost me. Patients ask thoughtful appropriate questions. If an appointment is needed a staff member calls them. Otherwise I can give an equally thoughtful response on my own time. As they say “It’s a win-win.”
Patients frequently preface a question with “I know doctors hate it when their patients look stuff up on the internet, but…” In typical doctor fashion I interrupt them at this point and say, “No I don’t, I like it when patients do that.” It takes a moment or two for that to take. Then they nod and ask whatever is worrying them that they’ve found on line.
The Google “pre-consultation” is a fact. According to research done by the Pew Research Center, 72% of internet users have searched the internet for health information. Many doctors I know, or at least the ones on social media, will pro-actively ask their patients “what did you read about it online?” This often relieves a couple of anxieties. First, that the doctor will negatively judge the patient for checking on line and secondly, the patient can proceed to ask questions about what is worrying her or him.
So when you come in to see me, instead of the “petit papier” with all your questions, I’ll expect them to be in a list on your smart phone or tablet (the paper is OK too). And if you want to send them in ahead of time, be my guest! Go to RelayHealth.com, register and send me your questions before your appointment. We can save time and cover more ground that way.
Oh, and when you are researching on the web, be careful out there. You can find lots of wrong information, chicanery and just plain bad advice on the internet. Here are my recommended web sites for disease searches:
It’s Saturday night and I’m tying up loose ends, signing off patient referral letters, sending messages to staff to do on Monday and “playing” in the test environment of our EHR to try to better understand it. My husband is working a 12-hour shift at an immediate care clinic, my daughter is with a friend and the cats are not trying to get in my lap right at this moment. The house is quiet, with nothing but the soft swishing noise the dishwasher makes and for some reason, that always soothes me. Maybe because cleaning is happening without my active participation. It occurs to me that I haven’t checked RelayHealth.com, our patient portal, since early yesterday morning.
I log on and there are two messages. One from a patient that needs her atorvastatin refilled. I thought it had been done at the time of our visit yesterday but when she arrived at the pharmacy only her blood pressure pills were there. Apparently I neglected to check the drop down box in the prescription area of our EHR. In her case the default setting was “record” instead of “send to retail pharmacy” (it varies per patient for some mysterious reason) and I missed checking ONE of the three prescriptions correctly. This is a system problem that needs to be addressed but in the meantime my patients will sometimes get less than all of the multiple prescriptions they need refilled. The good news is that she figured out how to use the portal, sent me a message, I read it and immediately logged back into the EHR system and sent the prescription to the pharmacy. Then I messaged her back to say the prescription should be ready in the morning. COOL! The second message is from a patient who has found data regarding the use of metformen and psychiatric disease. She is tech savvy and figured out how to scan and send me a PDF file of the published research. COOL! Now I’m learning from my patients even when I’m not in the office. I send her a message promising to read the article and get back to her and jokingly tell her that I hope all my patients aren’t as smart as she is or I’ll be inundated with reading material. Tomorrow I can respond to the article. So far not a large number of my patients know about or have bothered to sign up for the portal but I’ve been very happy with the interactions I’ve had on it. Earlier in the year a woman had an illness that seemed to linger forever. I was running tests and talking to specialists and was certain that this would pass but it was frustrating for her. I think it helped both of us that she could communicate directly with me throughout the illness and may have saved her some trips to the ER or Immediate Care Center because she had direct contact with me on a nearly daily basis. In return it was a relief to me to know how she was doing. Physicians often hesitate to give this kind of access to patients because they are afraid it will be abused but that is short-sighted. Just like with the telephone, I have complete control over whether I answer or my medical assistant does. This way it can be done at my convenience and, in general, I hate communicating by telephone. Most patient messages are quick and to the point. If they need to be seen, I tell them so. It’s a plus to patient care from my perspective and am pleased with the results. I hope my patients feel the same way.