E-Patient Update: Patients Need Better Care Management Workflows

Now and then, I get a little discouraged by the state of my health data. Like providers, I’m frustrated as heck by the number of independent data sources I must access to get a full picture of my medications, care and health status. These include:

* The medication tracker on my retail pharmacy’s site
* My primary care group’s portal
* My hospital’s Epic MyChart portal
* A medication management app to track my compliance with my regimen
* A health tracker app in which I track my blood pressure
* My Google calendar, to keep up with my health appointments
* Email clients to exchange messages with some providers

That’s not all – I’m sure I could think of other tools, interfaces and apps – but it offers a good idea of what I face. And I’m pretty sure I’m not unusual in this regard, so we’re talking about a big issue here.

By the way, bear in mind I’m not just talking about hyperportalotus – a fun term for the state of having too many portals to manage – but rather, a larger problem of data coordination. Even if all of my providers came together and worked through a shared single portal, I’d still have to juggle many tools for tracking and documenting my care.

The bottom line is that given the obstacles I face, my self-care process is very inefficient. And while we spend a lot of time talking about clinician workflow (which, of course, is quite important) we seldom talk about patient/consumer health workflow. But it’s time that we did.

Building a patient workflow

A good initial step in addressing this problem might be to create a patient self-care workflow builder and make it accessible website. Using such a tool, I could list all of the steps I need to take to manage my conditions, and the tool would help me develop a process for doing so effectively.

For example, I could “tell” the software that I need to check the status of my prescriptions once a week, visit certain doctors once a month, check in about future clinical visits on specific days and enter my data in my medication management app twice a day. As I did this, I would enter links to related sites, which would display in turn as needed.

This tool could also display critical web data, such as the site compiling the blood sugar readings from my husband’s connected blood glucose monitor, giving patients like me the ability to review trends at a glance.

I haven’t invented the wheel here, of course. We’re just talking about an alternate approach to a patient portal. Still, even this relatively crude approach – displaying various web-based sources under one “roof” along with an integrated process – could be quite helpful.

Eventually, health IT wizards could build much more sophisticated tools, complete with APIs to major data sources, which would integrate pretty much everything patients need first-hand. This next-gen data wrangler would be able to create charts and graphs and even issue recommendations if the engine behind it was sophisticated enough.

Just get started

All that being said, I may be overstating how easy it would be to make such a solution work. In particular, I’m aware that integrating a tool with such disparate data sources is far, far easier said than done. But why not get started?

After all, it’s hard to overestimate how much such an approach would help patients, at least those who are comfortable working with digital health solutions. Having a coordinated, integrated tool in place to help me manage my care needs would certainly save me a great deal of time, and probably improve my health as well.

I urge providers to consider this approach, which seems like a crying need to me. The truth is, most of the development money is going towards enabling the professionals to coordinate and manage care. And while that’s not a bad thing, don’t forget us!

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • Now lets imagine you are taking care of 1000’s of patients like you with all those disparate data houses. That is what you are expecting MDs to manage with the clunky, un-usable systems we have now. And you wonder why we have thrown our hands up. And yet the buzzword of “interop” is always thrown out there with little to no leadership on standards, usability, and lets get real here, no money to do it, only penalties for somehow “not” managing all this. Even if you somehow were the MIPS master and got a 4% -9% bonus on medicare patients, Lets say you did $200K in medicare, a 4% bonus is only 8K (9% is 18K). And we all know, not a single soul will get that high of a bonus, maybe penalties, but not bonuses. Do you think 10K would pay for all the workflow, IT, software, upkeep, etc.? Not a chance. Don’t forget you still have to pay for data extraction in MIPS, Registry costs, and the EHR costs. Do we really think that 10K covers even part of that? Pffft. no.
    So if you as a single patient are managing 10 data sources, multiple that by at least 1000 and you are asking MDs to handle that. Everyone wonders about MD burnout and why we don’t want to participate in this mess called MACRA.

  • Ms Zeiger:
    re your comment : “I urge providers to consider this approach, which seems like a crying need to me. The truth is, most of the development money is going towards enabling the professionals to coordinate and manage care. And while that’s not a bad thing, don’t forget us!”
    I will repeat the same offer I made to you on your March 4 2017 blog post:
    ‘I would be happy to discuss any of this with you via phone as a way to ‘shed light’ on many or most of the significant issues you have raised in this article. All valid points and very important for any patient needing medical care or information. Here is my contact # 919-870-7633 and do leave a msg just in case I don’t answer at the time. Or email
    Mom1952@aol.com and we can set up a mutually suitable time.’
    Best regards,
    L. Faith Birmingham MD

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