Kenneth Lin
First published 3/14/11 on Common Sense MD
Here is a brief excerpt from a narrative piece by internist Tasneem Bader-Omarali, MD in the February 25th issue of Medical Economics that encapsulates the limitless potential of integrating health information technology with patient-centered health care:
I was driving home after work one day when the answering service sent me a text. Mrs. Smith [a patient with chronic heart failure] was short of breath. I pulled over to the side of the road and, using my smartphone, logged on to my electronic health record. Mrs. Smith’s house was just a mile down the road at a nearby senior mobile home facility. On an impulse, I made a U-turn and drove to her house. Mrs. Smith opened the door and was taken aback. She invited me in.
During this impromptu house call, Dr. Bader-Omarali discovered that Mrs. Smith had been having frequent heart failure exacerbations because her German Shepherd suffered from the same condition, and had been feeding her pet her own pills because she was unable to afford to bring him to the vet. Without this visit (or her electronic health record, or her smartphone), Dr. Bader-Omarali may not have ever fully understood the reason for her patient’s poorly controlled symptoms, which she was subsequently able to address.
At any rate, the entire article, “The Lady with the Green Apples,” is well worth reading, along with the other award winners in the journal’s annual Doctors’ Writing Contest.
Care And Cost 
As helpful and important as the EHR and the smart phone were in this case, the most important thing was making that house call.
Neither PCMH, as defined by NCQA, nor technology, as defined by HHS, call for doctors to go visit patients in the home, quite the opposite actually, but it is this old-fashioned type of “doctoring” that seems to be yielding the best results – http://nyr.kr/fJYdtm – when combined with some technology.
Go figure……
I agree that having a smartphone helped this doctor in following her instincts and gave her a unique experience. Technology can be used and also abused! This dr used it very well!!
I came across this article on line, and others posted on Medical Economics, all of which I tend to read avidly. I am a RN and I have worked for a surgeon for thirty years. Back in the day, it was no big deal to make a house call like this doctor did. But today, doctors have so many patients and hospital work that this old fashioned care is unheard of. I have always thought that doctors tend to use too much technology and get more caught up in looking at the computer screen than the patient. But in cases like these, a smartphone can help change a doctor’s decision in the blink of an eye. Just ten years ago, this doctor would have to go back to her office, pull the chart, find the address and THEN go to the patient’s house – so she probably would not have done this at all. Or may she would. But the phone made it very possible!! A good read, thank you for the doctor’s article and your analysis.