Guyla C. Evans

1. The Intersection of Patient-Centered Records and Electronic Health Records and
Implications for Chronic Disease Management in America
Guyla C. Evans
HIMA 5060
Fall 2012

2. Contributing causes:
 Complexity of scientific knowledge
that practitioners need to manage
 Increased numbers of patients with
chronic conditions
 Poorly-organized delivery systems
 Constraints on leveraging
information technology to mitigate
the preceding circumstances

3.  100 million people with chronic
conditions
 $425 billion dollars in direct costs
 Additional indirect costs in time
lost from work, etc.
 One fifth of the population
considered “elderly” by 2030, as
baby boomers enter the ranks of
the aged

4.  Collaboration between the patient
and the health care team is
essential
 Patients need to understand their
treatment regimens, and the
implications for non-compliance
 Patients must buy into their
therapeutic regimens and act in
their own self-interests, sometimes
by performing self-monitoring
 Family members or caretakers may
be needed to help

5.  Care that is respectful of
and responsive to
individual patient
 preferences
 needs
 values
 Care that ensures that
patient values guide all
clinical decisions

6.  Strong sense of individualism
 Demanding consumers
 Intolerant of discrimination
 “Doctor Knows Best” doesn’t fly
 Greater percentage of singles
 May be caring for parents
 Higher risk for certain unhealthy
behaviors

7.  Patient Profile
 Chief Concerns (not complaints!)
 History of Present Illness
 Biomedical perspective
 Patient’s perspective
 Assessment and Plan
 HOAP, not SOAP
 Problem List
 Biomedical perspective
 Patient’s perspective
 Progress Notes
 Attending Physician’s Notes on
Teaching Services
 Hospital Discharge Summary

8.  About Me
 My Personal Health Goals
 My Ongoing Health Activities
 My Ongoing Action Steps
 My Challenges and Successes

10.  Appointment scheduling
 Health history
 Inquiries
 Diagnostic test results
 Patient education materials
 Integration with an EHR

12. EHR’s
Patient
Portals
Patient-
centric Care