Navigating the Health Care System
Advice Columns from Dr. Carolyn ClancyFormer AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.
Health IT Tools Help with Care and CostsBy Carolyn M. Clancy, M.D.
More hospitals and doctors' offices are using health information technology (health IT). And that's good news for patients.
One of the most popular uses of health IT is the electronic health record. These records put your health data—medical history, medicines, allergies, test results, and more—all in one place. This saves you and your medical team time. It also reduces the chance of an error like getting a drug you're allergic to. A complete electronic health record is particularly helpful in an emergency.
Other types of health IT tools can help your medical team provide safer, more effective care. They can also assist you in making good decisions for you and your family.
Work supported by my agency, the Agency for Healthcare Research and Quality (AHRQ), shows how health IT tools can save time and money. They can help prevent trips to the hospital emergency room (ER) and even prevent life-threatening conditions.
For example, when kids get sick at school or day care, parents often must leave work to go to the doctor's office or hospital ER. Just over half (57 percent) of men and women had access to paid sick days in 2009, a recent survey found. That means that minor illnesses that can be easily treated can end up costing a lot of money in health bills and lost wages. But technology is allowing a child's own doctor, with parents' permission, to make a "virtual" office visit to schools and day care centers.
Through technology, trained assistants can use equipment, like special cameras and an electronic stethoscope, to arrange virtual visits with children's doctors. Physicians diagnose, prescribe, and discuss treatments with parents and school staff over a secure Internet connection.
The Health-e-Access Telemedicine program has lowered health costs by more than 23 percent by reducing ER visits. The program includes 10 child care centers and 12 elementary schools in the Rochester, NY, area. It is now expanding to assisted living and senior day care centers.
Pressure ulcers, or bed sores, occur when patients stay in one position too long. People who are bedridden or use a wheelchair are at risk. If not caught early, pressure ulcers can cause serious infections and even become life-threatening.
A computer program called On-Time helps identify patients who are likely to develop pressure ulcers and then creates special care plans and reports. It encourages nurses, nursing assistants, dieticians, and others to work closely on care planning and follow up. In the 21 facilities that used this program, the incidence of pressure ulcers declined by more than 42 percent.
On-Time is now used in more than 75 nursing homes. New research may show how to prevent other problems in nursing homes, such as falls.
Of course, the best computer program is no substitute for dedicated health providers and involved patients and families. But when you or a family member gets sick, health IT tools can provide new options for better quality and lower costs.
I believe these tools enhance, not replace, the doctor-patient relationship. They also make it easier to deliver the right care to the right person at the right time.
I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.
Agency for Healthcare Research and Quality
Healthcare 411: Radiocast/Podcast, March 2, 2011. Keeping Kids in School via Telemedicine. Available at: http://healthcare411.ahrq.gov/radiocastseg.aspx?id=1179&type=seg [Transcript]
Healthcare 411: Radiocast/Podcast, March 16, 2011. Preventing Bed Sores. Available at: http://healthcare411.ahrq.gov/radiocastseg.aspx?id=1183&type=seg [Transcript]
AHRQ-Funded Projects. Health IT Implementation Stories. Long-Term Care Facilities Embrace Health Information Technology. Available at: http://healthit.ahrq.gov/portal/server.pt?open=514&objID=5562&mode=2&holderDisplayURL=http://wci-pubcontent/publish/communities/a_e/ahrq_funded_projects/health_it_implementation_stories/healthitimplementationstories/long_term_care_facilities_embrace_health_information_technology.html
AHRQ-Funded Projects. Health IT Implementation Stories. Telemedicine Project Connects Kids, Doctors for Better Care. Available at: http://healthit.ahrq.gov/portal/server.pt?open=514&objID=5562&mode=2&holderDisplayURL= http://wci-pubcontent/publish/communities/a_e/ahrq_funded_projects/health_it_implementation_stories/healthitimplementationstories/ telemedicine_project_connects__kids__doctors_for_better_care.html
Institute for Women's Policy Studies
Paid Sick Day Access Rates by Gender and Race/Ethnicity, 2010. Available at: http://www.iwpr.org/initiatives/family-leave-paid-sick-days
National Library of Medicine
Pressure Ulcer: MEDLINEPlus Medical Encyclopedia. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/007071.htm