Monday, September 26, 2011

Talking to your Doctors, Getting What you Need

There has been a lot of discussion about patient/provider communication, partially driven by the move to electronic health records and the question of who has access to the contents of that record, and partly driven by a heightened awareness among patients that they must control their health destiny because basically no one else will. 

Some even contend that patients should have access to their lab reports. But let’s face it, most patients do not know how to read these reports, nor do they want to. To resolve this dilemma, and help patients become more empowered and engaged, they need   easy tools such as lists of questions to ask, when they are in front of their physicians and other healthcare providers, and a notebook to jot down answers. Some even need an advocate with them to help them understand and remember the physician’s instructions.

In Chapter one of  my book, e-Patients Live Longer, The Complete Guide to Managing Healthcare  Using Technology,, I provide  suggestions for the reader to think about regarding what outcome they want from a visit with the doctor; what characteristics make a good patient and key questions to ask during an annual checkup.

Just last week, the Agency for Healthcare Research and Quality announced that they had a Question Builder Tool on its website that outlines the kinds of questions patients should ask when seeing a doctor. Question Builder is a great tool for patients who know where to find it. Unfortunately not many people will search it out or take the time to go through all of the links and choose the questions that are relevant to their care.

 If providers really want to help empower their patients, and make their time with patients more efficient, they have to suggest these resources to their patient population.

Will this format for communication save time and money. You bet it will. The patient will experience fewer redundant tests, medication side-effects will be reduced and fewer errors will occur. Patients will be more compliant about following treatment plans and more educated about their health issues. This has long enough been discussed. Now is the time for action.

Tuesday, September 20, 2011

E-Patients Need to Strike Out against Hospital Acquired Infections

Empowered patients not only have to be good communicators, who know how to use the Internet for research and networking,  you have to be aware of what is going on around you and savvy enough to take appropriate action in situations where there are no specific  rules. That is what keeps you  empowered and in charge of your health. One example of that is to understand the dangers you face as a patient in the hospital, and   what you can do to address those dangers.  

Hospital-acquired infections (HAIs) are among the top five leading causes of death in the United States, striking 4.5 of every 100 patients admitted to a hospital. As an e-patient you do not want to be one of those statistics. A recent study released by the American Journal of Infection Control, (Sept., 2011, Vol. 39, Issue 7, p. 555-559)   reports that many of these acquired infections could be caused by bacteria and pathogens that linger on hospital staff uniforms .and other clothing worn by doctors, nurses and hospital workers.

 A team of researchers, led by Yonit Wiener-Weil, MD from the Shaare Zedek Medical Center in Jerusalem, Israel, collected swabs samples from the uniforms of nurses and doctors and found that fifty percent carried pathogens on their pockets, sleeves and waists of their clothing, particularly the scrubs and lab coats that they wore when they were in direct contact with patients. Other studies have found that hospital bed handsets, TV remote controls, cell phones of hospital staff were also found to contain biologic material that could be contaminated with disease-causing microbes.

It would seem obvious that hospitals need to go back to the practice of several years ago when they laundered the scrubs and lab coats used by doctors and other workers.   They also need to make sure that hospital issued clothing does not leave the hospital and come back in the next day,  and that street clothing worn by individuals who have direct patient contact need somehow to be sanitized each day. Additionally hospitals need to adopt programs to sanitize equipment such as bedside remotes, cell phones, and other electronic devices that patients and workers use, so they will not carry these pathogens around the hospital and spread the incidence of HIAs.  

There is also the issue of hand hygiene. Following the H1N1 scare, hospitals, doctor’s offices and other institutions, instituted stricter hand washing policies and installed hand sanitizer dispensers in key locations. They launched a major campaign encouraging people to be more diligent about hand washing, especially healthcare professionals who were in contact with patients or with lab equipment. 

There are steps that e-patients can take to avoid exposure, including:

1.    In your bag that you take to the hospital pack a large bottle of hand sanitizer and a disinfectant or wipes that you can use to clean the equipment around your bed. If you are too ill to do this, ask your advocate (family members or friends) to oversee this task.

2.    Be diligent about cleansing your hands and ask your doctors and nurses directly if they washed their hands  before examining you

3.    Check out the hospital where you are planning to stay. There are websites for that purpose such as: or

4.    Take direct action. Send messages to you hospital officials to advocate for safer hospital practices; Volunteer to work with hospital officials on initiatives that address this problem. Solicit other patients to get behind this effort.