Patient Experience

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Revision as of 13:46, 25 October 2020 by Tom (talk | contribs) (Patient Consent)

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Full Title or Meme

A good medical Patient Experience is only created where the patient is informed and involved in their care plan.

Context

  • This experience document focuses on only two subjects, the patient and the provider. It may be that others are involved or that different names are given to the subjects, but in the majority of cases there will be a mapping to these two subjects.
  • While the most significant part of the patient experience might be the outcome, this page focuses on the part of the journey that leads to that outcome, but not on the outcome itself.

Problems

In the absence of a single payer health care network, the US is blessed with a plethora of solutions, but plagued with the resultant lack of interoperability. As a result it has been impossible in the past for user's to effectively carry their health history around with them as the move about the country or even across town.

Solutions

Patient Identifiers

  • The patient is assumed to go through some sort of registration process with the provider's practice and is "known to the practice".
  • A Medical Records Identifier will be assigned by the practice so that it can recall its own interactions with the patient.
  • Every other practice that the patient visits will likewise create a Medical Records Identifier that it uses to track the patient.
  • There will never be a good Patient Experience where the patient needs to know any of these Medical Records Identifiers.
  • On subsequent visits to the practice, and at each care station within the practice, the patient will be reidentified in an appropriate simplified protocol.

Patient Histories

It is generally agreed that it is better for doctors to have a full set of patient health histories to enable adequate care, especially in life-or-death emergency cases. FHIR, pronounced 'fire' is working on Information Sharing APIs, and the details of that is not addressed here. This page basically assumes that the information sharing part actually is deployed and works reasonably well.

  • Patient histories are available to the patient on demand. A good Patient Experience will provide a complete set of records for the patient. These records are likely to be voluminous, so a paper set of records is to be discouraged.
  • At the end of every care visit the patient will be provided with medical records of the visit that the patient can understand as well as changes to the care plan THAT THE PATIENT HAS SEEN WITH THE PROVIDER, UNDESTOOD AND AGREED TO.

Patient Care Plan

  • The best Patient Experience will come from empathy with the patients journey, including the fear and discomfort that they will inevitably experience.
  • The only valid care plan is one that the patient understands and agrees is best for them.

Patient Consent

  • See FHIR Resource Consent - Content Abstract: FHIR provides a Consent resource suitable for use by FHIR clients and servers to record current Privacy Consent state. The meaning of a consent or the absence of the consent is a local policy concern. The Privacy Consent may be a pointer to privacy rules documented elsewhere, such as a policy identifier or identifier in XACML. The Privacy Consent has the ability to point at a scanned image of an ink-on-paper signing Ceremony, and supports digital signatures through use of Provenance. The Privacy Consent has the ability to include some simple FHIR centric base and exception rules.
  • Consent Receipt - need to find a user friendly description ****

Patient Follow-though

  • The care plan may not work and the patient may not communicate that with the provider.
  • While technically the patient has the responsibility for following the agreed healthcare plan the provider must recognize:
  1. The patient may agree, but not understand what the instructions mean, or not accept the effort, cost or experience of following the plan.
  2. The patient may not have the ability to remember or perform all the steps required.
  3. The patient will get other advice from professional and commercial sites that contradict the care plan.

User Research

  • The only way to judge the patient's satisfaction is to ask them.
  • The only way to improve the patient's satisfaction is to try different strategies and, again, ask for feedback.

References