Informatics: Empowering ePatients to Drive Health Care Reform

Citation: Nelson, R., (September 13, 2016) "Informatics: Empowering ePatients to Drive Health Care Reform" OJIN: The Online Journal of Issues in Nursing Vol. 21, No. 3.DOI: 10.3912/OJIN.Vol21No03Inf°Col01Historically, the American healthcare delivery system has rewarded providers for the number of patients seen and procedures performed. For example, seeing twice as many patients in a day resulted in more income for providers; and admitting more patients to a hospital enabled the hospital to collect more money. Today, the American healthcare delivery system is transitioning from a volume-based approach to a value-based approach. As this transition progresses, providers will be increasingly rewarded for the quality of care provided as measured by patient outcomes; ePatients are now one of the major force driving this transition. In this my first column (Part I of three columns on empowering ePatients), I will describe who ePatients are, introduce the reader to real ePatients and eCaregivers, and discuss how ePatients are being empowered to drive this transition.Part I: Introduction to the ePatientIn 1955, Virginia Henderson first published her well-recognized definition of nursing. Early on Henderson defined nursing as "assisting the individual (sick or well) in the performance of those activities contributing to health, or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. It is likewise the unique contribution of nursing to help the individual to be independent of such assistance as soon as possible" (Harmer & Henderson, 1960, p. 4). Implied in this definition, as well as many other definitions of nursing, is the idea that an educated professional nurse would be responsible for providing the care that a patient could not do for him or herself. To meet this responsibility, nurses have developed a systematic process called the nursing process.Today, the role and responsibility of the nurse is changing. Healthcare is moving from a world where the educated, informed nurse offers services to patients who cannot meet their own healthcare needs to a world where the equipped, enabled, empowered, and engaged patient is becoming a peer, working together with nurses and other healthcare providers in identifying their healthcare needs. The final decision about how these needs might best be met is being placed in the hands of the patient. In truth, patients were always supposed to be in charge of meeting their needs; this is one of the reasons there are so many permission forms in healthcare. In this first column (Part I) in this three-part series on empowering ePatients, I will explain who/what e-Patients are, introduce the reader to real ePatients and eCaregivers, and explore the concept of empowered ePatients and eCaregivers.What is an ePatient?In today's lexicon there is a long list of eWords, for example, eHealth, eMail, eShopping, and eLearning. The small e in front of the term is used to denote that the object or activity exists or is occurring in electronic format in an online environment. However, use of the term ePatient precedes many of these terms. Tom Ferguson, who began studying and writing about the 'empowered medical consumer' in 1976, while he was still a medical student at Yale (Thomas, 1978), coined the term e-Patient. He defined e-Patients not as electronically connected, but rather as equipped, enabled, empowered, and engaged in their health and healthcare decisions. (Society for Participatory Medicine, n.d.).Since Ferguson first coined this term, its meaning has continued to evolve and expand. For example, the Stanford Medicine X ePatient Program has now defined an ePatient as follows:ePatient (e-pa-tient/e'paSHant/): 1. A health consumer who uses the Internet to gather information about a medical condition of particular interest to them, and who use [s/c] electronic communication tools (including Web 2. …