A Friendly Reminder: Preemptive Measures against Non-Adherence

It’s frustrating when people in our lives come to us for assistance, advice, and guidance, only to blatantly ignore what we offer them. This could be a sensible plan for weight-loss, a way to end an abusive relationship, or a balanced structure for productive daily living. Despite your time, effort, and energy, they fail to follow through, and return to their old habits.

This phenomenon is commonplace. Again, it is frustrating for most people, and maybe even a bit disheartening. We don’t want to see those we know slide farther into unhealthy territory. For physicians, there is much more at stake. Frequent patient non-adherence can seriously affect a practice’s bottom line. Persistent tardiness, failure to show for appointments, ill-informed resistance, and general lack of follow-through with treatment plans all cost physicians money.

As with many afflictions, there is no singular wonder-cure for patient non-adherence. There are, however, very pragmatic approaches to dealing with the issue, made up of equal parts diligence, communication skills, and technological savvy. We will discuss a few in today’s post.

EHRs, revisited

No, they aren’t perfect. They do not yet “communicate perfectly” with each other. At times, the old system of note-dictation seems a better alternative for keeping and updating patient records when compared to managing the multiple windows and pull-down menus. Rest assured, though, that they have come a long way, and continue to improve. To begin with, they decrease the number of “blind-spots” inherent in physical charts.

“Blind spots” refer to data that is conspicuously missing—gaps in treatment, or other inconsistencies: a male patient, forty-five years old, who has never undergone a colonoscopy, or a similar female patient who hasn’t received a mammogram in many years. Using this data, doctors can execute outreach programs, leveraging patient portal, phone, e-mail, and text notification. These are designed to remind patients about everything from yearly checkups to flu vaccines and cancer screenings.

This preventative measure zeros in on a potential problem before it reaches a crisis point. This is when treatment becomes intensive, frightening, and expensive. Needless to say, if executed properly, this system can save physicians not only boatloads of time, but money as well. Think of how many work hours, or how many additional employees it takes to mine a patient’s history the conventional way, or with an outdated EHR.

Other EHR models

There are a variety of EHR programs and vendors to choose from. If you are thinking of scrapping your current EHR for a better option, consider first its operating paradigm. (Now there’s a fifty-cent term for you.) What we mean is, think about how you personally process a patient’s information. What questions do you naturally ask yourself? If you think first about those health issues, or potential health issues which need to be addressed, then there is an EHR model out there for you.

“Problem-based EHRs”, like InLight and Amazing Charts, allow doctors to index patient care based on clinical problems, from high blood-pressure, to chest-pain, and well beyond. Tests, diagnoses, and prescriptions are intuitively tracked and linked over time. The EHR examines your decision patterns relative to certain health problems, your preferred modus operandi, as it were, for treating them. It uses these patterns to auto-populate certain fields, saving you lots of time in the process.

Seamless Technology

Maybe they don’t play as nice together as we’d like them to yet, but EHRs may just get along famously with other technology. Take Apple’s HealthKit for example. This software collects information from a variety of other health and wellness apps, then makes it easily accessible to users through Apple’s Health app. Certain medical organizations are actively building upon this technology, developing additional apps that will work in conjunction with HealthKit to collect and transmit data from devices like scales, blood pressure cuffs, and sleep apnea monitors directly to a patient’s EHR.

Up-to-date information. Streamlined records. Active involvement by both patient and physician. The (near) future is looking pretty bright.

The right vocabulary

Whether it’s expressed in an e-mail, voicemail, or a face-to-face conversation, you must choose your words carefully when dealing with an uncompliant patient. Setting up channels is the first step. Persistence is the second. Panache is the last.

There is no shortage of information out there. On anything. Unfortunately, this doesn’t extend to factual information. Trends in pseudo-medicine, or other misleading information can have a negative effect on patient adherence. You must be ready to counter fiction with facts. This doesn’t mean shooting it down, or criticizing your patients. Remain open to their preferences. It is sometimes possible to dovetail both traditional and alternative, or natural treatment. Try to educate them about the benefits of treatments and medications.

Above all, be persistent.

Brian Torchin

| HCRC Staffing | Brian@hcrcstaffing.com | www.hcrcstaffing.com

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