The hospitalist model of care may adversely affect the transition to or from the hospital by interrupting the flow of information between providers. The resulting information chasm has been related to readmissions, adverse events, and criticism of the hospitalist movement. Though electronic health records (EHRs) improve information access, they may represent part of this problem by (1) limiting access to those with secure credentials, (2 proprietary/institution specific design, and, (3 isolating patients and their families from their health data (Fig. 1). As we in medicine struggle to share information effectively, social networking sites such as Facebook have revolutionized interpersonal communications. Can Facebook teach us about health information sharing?
FIGURE 1. Left, current state of health information flow within silos specific to place (hospital) or person (provider); right, proposed Web‐based online “cloud” with instantaneous patient‐driven control of health information.
To conceptualize a “cloud‐based,” collaborative, patient‐centric health‐information solution that would revolutionize health information sharing.
In our proposed model, patient health information would be available through an online, Web‐based, patient‐controlled information exchange like Facebook. Patients (not providers) would create online “friendships,” inviting all invested in their care (physicians, therapists, social workers, pharmacists, and family members) to the same (Web) page. A typical patient page might contain demographic data, problem lists, medications with recent changes, and elements such as brief narratives of care or important follow‐up reminders, much like contemporary EHRs. Providers granted access by patients could post clinical summaries, admission/discharge notes, medication lists, or answers to patient queries, thus weaving a novel, virtual physician–patient relationship. Patient pages would be accessible to all providers at all times, not just those at 1 particular facility. Similarly, family members could participate in patient care simply by monitoring pages. As architects of their “online health hub,” patients might invest greater effort into their health agenda. For example, a patient could find answers to what medications they should be on, how to take them, or who to contact in the event of an emergency after discharge if they had ready access to this information. Finally, a patient might choose to use their health page to share select information with others, creating mutual engagement for diseases that are common, chronic, or otherwise isolating (Fig. 2).
FIGURE 2. Conceptual model illustrating patient controlled data sharing between multiple stakeholders (providers, families, facilities, etc).
A Web‐based, patient‐controlled collaborative data‐sharing model provides many advantages over current EHRs. By placing control of sensitive information into patient hands, HIPAA is preserved, and data sharing is facilitated between patients, their families, and providers. A research enterprise dedicated to further studying this concept, its limitations, and optimal implementation could profoundly affect patient safety, care, and outcomes.
V. Chopra ‐ University of Michigan Health System, employer
To cite this abstract:Chopra V, McMahon L. Readmissions, Facebook and Information Sharing: Lessons Learned for Future Paths. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 161. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/readmissions-facebook-and-information-sharing-lessons-learned-for-future-paths/. Accessed April 1, 2020.