With technology at their fingertips, patients are becoming more empowered and involved in their health care treatments, many times knowing what their illness is before going to the doctor. Patients are demanding better care by conducting their own research of hospital costs, creating competition among hospitals for patient attendance with “user experiences” like the ability to order hospital meals via a touch screen tablet. These patients are part of what is known to the medical community as the e-patient movement.
 
E-patients, or electronic patients, are recognized as patients that are, as Scott Mace of HealthLeaders Media noted, empowered, engaged, equipped and enabled. These patients do their own research on their health and diagnoses, and do not rely solely on the advice of their doctor(s). Don S. Dizon, MD, has come to expect patients to enter his office with their self-conducted research, complete with complex and knowledgeable questions on their health.
 
The Patient Voice
According to Health Online 2013, 72% of internet users say they have gone online to research medical symptoms to discover what kind of illness they, or a loved one, might have. Part of that 72% is Regina Holliday, the face for the e-patient movement and founder of The Walking Gallery of Healthcare. Regina’s story began in 2009 when she failed to receive her ailing husband’s medical records in a timely manner. Regina wanted access to his records to conduct her own research on his disease, but due to cost, delay, and lack of proper protocol, Regina received her husband’s records only a month before his passing. Regina’s experience empowered her to bring the movement of the e-patient to the forefront. As a result, Regina founded The Walking Gallery, where people raise awareness for the e-patient through the patient stories painted by Holliday and portrayed on the backs of jackets and doctors' coats.

In the five years since Regina’s movement began, one health system, in particular, has received recognition for the integration of its electronic health record (EHR) technology in an initiative known as Care PATH (patient-centered access to team-based healthcare). Catholic Health Partners’ Stephen Beck, CMIO, explains why Catholic Health Partners’ integration stands apart:
 
“Our project is a clinical project, not an IT project, and it has been led by a coordinated team of clinicians across our enterprise since our rollout began. Our providers helped design critical areas of our build and are constantly giving constructive feedback toward enhancing our system. Provider input, not simply physicians, but mid-level providers, nurses, pharmacists, therapists, and others is essential to the success of any EHR implementation, and it is essential to its continued success. The patient must be at the center of this transition. Our largest struggle is not with the patient who takes their medication regularly, but with the patient who does not engage in their own care. Technology can be the driver that excites a patient with the prospect of wellness.”

Doctors are seemingly getting the hint that patients are looking for a more involved role in their care. As Gary Garofalo of Maximus noted after this year’s HIMSS Conference, “the health delivery system is shifting from a physician-centric model to a patient-centric model.” In his article “Patient-centric healthcare means revised definition of quality,” Bruce Chernof, MD, President and CEO of The SCAN Foundation, is very precise in saying that the quality of patient care needs to be measured by the patient’s values:

“To fundamentally engage the American public in the future of the healthcare delivery system, we need to see value through their eyes as they endeavor to live their lives to the fullest despite limitations. This can best be achieved by putting quality-of-life measures on the same level with quality-of-health measures to truly drive health system change.”
 
Technology and the Educated Patient
In addition to becoming more involved in treatment options, e-patients are taking control of costs, as well, made possible in part by the Centers for Medicare & Medicaid Services making hospital costs and physician data  public. Using the data and information provided, patients are able to “shop around” to determine where a procedure will be the cheapest. New York Times created an interactive map that allows people to put in their zip code to find the costs of the same procedure at different hospitals.
 
One New York Times article revealed that, in Saint Augustine, Florida, “one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Florida, charged $91,000.” The revelation of such drastic variance in procedure costs prompted the empowered e-patient to ask the question, “Why?” Today’s more informed patient is, thus, less inclined to accept the prices slapped on procedures without specific financial information as to what birthed that number.
 
Technology continues to lend a helping hand to the e-patient through the creation of consumer apps made specifically for health care costs. Wondering what your tonsillitis will cost at the hospital three miles down the road or at the hospital in the next town over? There’s an app for that. UnitedHealthcare’s free Health4Me app and the company’s myHealthcare Cost Estimator both offer patients pricing on more than 520 medical services and procedures. Apps centered on managing care, and not just costs, are also empowering patients. Medscape.com provides a good list of some of these healthcare apps.
 
The e-patient also has an empowered patient coalition on their side, designed to help give patients a louder voice in healthcare. Detroit Medical Center’s Harper University and Hutzel Women’s Hospitals have implemented smart rooms to “empower patients and their families by connecting them to their personal health record right at the bedside.”
 
The Parkland Medical Center in Dallas, Texas is another example of hospitals using technology to create better customer experience for its patients. New tech savvy plans include a digital media wall with recording and video calling capabilities in the labor and delivery rooms for patients who wish to have faraway family present during delivery. Altruista Health offers these tips for creating a more patient-centric environment.
 
From the creation of apps designed to keep people healthy and those helping people keep healthcare costs down, to pricing transparency and technological advances and in hospitals, the e-patient movement is pushing full speed ahead and shows no sign of weakening. Hospitals have no choice but to yield to the patient who is, after all, the hospital’s most vital team member.

Join Porter Research and Billian's HealthDATA for an ePatient Tweet Chat on Thurs., Oct. 2nd, at 1pm ET, as we put aside our healthcare professional hats and offer up a genuine, educated consumer's take on e-patient engagement in healthcare. Learn More >>