Providing portable, understandable health histories empowers patients

LETTER — Posted April 30, 2012

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Regarding “The ABCs of health literacy” (Article, March 19) and “The EHR: It’s about our patients, not technology” (Article, March 19):

Each of these articles emphasizes the importance of deliberate efforts by health professionals to enhance patients’ understanding of their health. In response, I want to share with your readers efforts that I have undertaken in my internal medicine practice to educate my patients about their health, which also have transformed my practice.

About 15 years ago, I began to give each of my patients a medical problem list. Each medical term on his or her problem list was followed by a patient-friendly explanation of the problem. At first, this was a handprinted problem list created by me after reviewing each patient’s chart and talking with him or her. My patients responded so enthusiastically that each subsequent year, I tackled a different aspect of their health histories.

One year I updated their social histories; the next, their preventive health tests; the next, their medicine lists; and so forth. Each entry in the medicine list, for example, would contain, in patient-friendly language, the trade and generic names of the medicine, the dose, and how and why to take the medicine. I take care to maintain the health histories to be simultaneously valuable for both health professionals and my patients. These compilations went from being handprinted to typewritten to word-processed and, finally, to be contained in an electronic health record.

Presently, at each periodic health exam (usually annual) I will update a complete health history and give it to a patient in full and wallet-sized copies, along with a study guide. All of my patients carry their entire health histories in their wallets in case they may need them in a medical emergency (in the future this material might easily be downloaded onto a flash memory device or a secure app).

The health history process has informed my patients and transformed my practice. I am able to use the health histories as checklists to organize the way that I care for my patients. Using this approach I have been able to achieve very high success rates with my patients in preventive health interventions.

Furthermore, the shared, patient-friendly health history empowers my patients to be active participants in their health care. I predict that in the future, every patient will possess a health history. I also believe that primary care health professionals are the perfect individuals to create and maintain patient health histories, and that by doing so, primary care will re-establish its position at very center of medicine.

Robert L. Alt, MD, Madison, Wis.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2012/04/30/edlt0430.htm.

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