Adult primary care physician, David Ziegelman, talks us through the uses of My Heath Online, UVM Medical Center’s online health records system, for both patient and physician and introduces us to the new mobile application. Listen to the interview or read the transcript below.
UVM Medical Center: Wouldn’t it be nice if you could see your lab results and medical records anytime you wanted? Or refill your prescriptions, ask your doctor questions and make appointments without having to get on the phone? It turns out you can already do all of that and more from your computer using a website called MyHealth Online. Thousands of UVM Medical Center patients currently are taking advantage of this convenient way to manage their health, and on today’s program you’ll learn a lot more about how the system works and what you can get out of it. We’ll also be talking about a new app version of MyHealth Online available for smart phones and tablets.
Here to fill us in is Dr. David Ziegelman, an adult primary care physician at the UVM Medical Center, located at 1 Timber Lane in South Burlington, and an assistant professor at the Larner College of Medicine. Thanks for coming.
David Ziegelman: Thanks very much for having me.
UVM Medical Center: Add to that very brief description of MyHealth Online. It is a pretty cool, convenient thing.
David Ziegelman: Absolutely. I think in the past, people pretty much discussed their medical care when they came in to see their doctor, and medical records were in paper form. Now, since we do things on computer, people can have access to their health care records, health care information, lab tests – all that sort of thing – from home, or from their phone. That allows them to stay on track, be up to date and interact about their health care much more than they could before.
UVM Medical Center: There’s the convenience factor to it. Do you find that people do interact more, like they’re emailing their doctor and using that function?
David Ziegelman: Yeah, we consider this a way to help people get more engaged in their health care and we see people really appreciating things like getting their test results. In the past, we would have to, say, write things out in a letter and send people a letter, and that would take quite a while to get there. Now, they get their lab test results or X-ray results within a day or two, often with a comment from us indicating that things are okay or not okay, that sort of thing.
People seem to really appreciate being able to get their results in a timely fashion. They also can look at the results and compare it to the past. If you’re monitoring your cholesterol and you’ve been working really hard on it, now you can see your old cholesterol, what it was last year and the year before, which I think people appreciate.
UVM Medical Center: It’ll come up in a bar graph, or there’s a couple of different ways to display that information.
David Ziegelman: That’s true, there’s a couple of different ways to show it, kind of illustrate how you’re doing. There are other features, for example, everything having to do with appointments. You can request an appointment, you can check an appointment. I personally tend to forget when my appointment is, so I just check it. You can ask for the appointment to be changed.
Similarly, you can ask questions and send messages to either your primary care doctor or a specialist, whoever you see for your care. There’s a whole messaging feature where you can ask questions. They’re not supposed to be emergency or urgent questions but usually we get back to you within a day or two.
The nice thing about it is you can think of your question at midnight or 6 am and not have to be thinking about calling. Similarly, our staff can get to it when they’re ready to during the day, and the doctors can do it during the day or even in the evening when they’re doing their work.
UVM Medical Center: What do you find, when you talk to patients about it, that they like the most about it?
David Ziegelman: I think I mentioned being able to get their results and have access to it is probably the thing that they appreciate the most, being able to ask the questions like we mentioned. We didn’t mention renewal of medicines. You can very easily ask for refills online or from your phone, and I think people really appreciate that as well.
UVM Medical Center: I should say, I’ve used this myself and find it to be very easy. My physician is very responsive, and I do like that feature – being able to look back and track things. I would think that would help, as you say, with cholesterol, ongoing problems like that. One thing I haven’t taken advantage of is paying your bills, but you can do that, too, right?
David Ziegelman: That’s true. When you log on, the first page that you see sort of on the left half, has to do with your medical history, your appointments, that sort of thing. The right half, you click on there, that’s for bills. You can see what your bill is, you can pay your bill from that location.
UVM Medical Center: If you’re just tuning in, we’re talking to Dr. David Ziegelman. He is an adult primary care physician at the UVM Medical Center and assistant professor at Larner College of Medicine. Our topic today on Health Source is something called MyHealth Online. It’s a website and now an app – and we’ll be getting into that in a minute – that allows you to really manage your health in a convenient way and in a secure way, which is what I wanted to get to before we go too much farther, because that’s a concern right away. People have just heard you say you can see your test results online, and might be thinking, who else can see them? Describe the measures you take to keep it secure.
David Ziegelman: That’s a very good aspect of this. It is a secure, encrypted messaging system, and we’re very careful about when we give the rights for someone to see their medical information, that we know that that’s that person. No one else can see it. In other settings, sometimes people do email, texting, things like that, and that is not considered to be safe, so we’ve moved towards this platform, which is much safer.
UVM Medical Center: Speaking of other people having access, there is a system whereby you can manage the health care record of, say, an elderly parent or a child, right?
David Ziegelman: That’s correct. We call that being a proxy. For anyone who’s over 18, let’s say an elderly parent who’s not very computer savvy, basically what happens is, it’s the same as doing MyHealth Online as if you were that patient. Except now you can see, as the proxy, you can see their information. The one key step is that that patient has to give the okay to allow that proxy to have access, and that patient can say “no more access”. We use it a lot in our clinic for elderly patients whose children are actually actively managing their care and helping with their care.
We do it for pediatrics, too. If a child is less than 12 years old, when you sign up for MyHealth Online for that child, the parent is the person who checks in. Once they’re 12 to 18, the child actually can have an account and see their own health records, etc. and they can give access to the parent. They can also have access for the parent but choose on an occasional basis to send a message to their doctor and actually have the parent not see that. For example, they may want to have information about birth control or something like that. We want to be able to allow them to be able to communicate with their provider in a private way, so there’s several different levels. That means that you can allow parents to have full access except when the teenager decides they want to have their occasional message back and forth.
It’s been well thought out. It’s very interesting and the idea is to allow parents to be involved for sure with kids under 12, and have them be involved to the level that the teenager feels comfortable and then, after 18, they’re probably on their own. Once you’re dealing with elderly patients, then a family member may be involved as well.
UVM Medical Center: We’ve talked about value for patients. How do you think it has had an impact on physicians? Does it help you folks do your job?
David Ziegelman: Yeah, I think it does. First of all, we appreciate having patients more engaged in their health care. Our goal is to have our patients do better in their health, so anything that helps with that, we’re on board. There are some practical things that are useful. Just in my everyday life, I review a lot of results that are coming in. When I see lab tests and the person is signed up for MyHealth Online, I can fairly quickly just make a little comment on the lab and send it right out to them. Whereas if I have to do that in a letter and have that printed up, it’s a more laborious process. I find it to be more convenient and quicker.
When patients are engaged and involved, for example, you can see which preventative health items or procedures or vaccines are due, it says the person is due for a physical or they’re due for a tetanus shot. People will see on MyHealth Online that it’s due and contact our office or they’ll use MyHealth Online to contact us. Now, they’re engaged and they’re doing things on time and that gets things done in a very efficient way.
UVM Medical Center: It impacts health, not just the convenience factor.
David Ziegelman: Exactly, it keeps them on track and gets them involved and them understanding their own health better.
UVM Medical Center: Let’s talk about the app, because that’s a newer aspect of this. What’s the app like and can I do everything on it we’ve just been talking about?
David Ziegelman: The app can do everything we just talked about. It’s a little more streamlined, which makes sense, because it’s trying to fit on the phone. I think it’s very cleanly designed and pretty intuitive, and it essentially allows you to do those things we just mentioned – make appointments, communicate with your provider, check lab tests. An example of what you can’t do is see a graph of your past lab tests. That’s just an example. In the future, we’ll be able to do that. The vast majority of the things that you can do on the website, you can do also do on the app.
UVM Medical Center: I forgot to ask earlier, you can see lab tests but can you see your entire medical record, like all of the appointments that you’ve had and the notes from the doctor?
David Ziegelman: You can see past visits and what the reason for the visit was and some basic information about the visit. You don’t actually see the notes that the doctor wrote, for example. However, in the future you’re going to be able to see exactly what the doctor wrote for your visit. That’s a very big change for us and that’s pretty cutting edge, but it turns out that most people do want to see what is in their record and that just advances that edge of seeing more and more available for the patient.
UVM Medical Center: People do want more information now, and I think the general feeling is that people want to feel a little bit more in control, they want to know more about options. They come into your office armed with a lot of stuff they’ve read on the Internet and you have to tell them what’s true and what’s not true, but there is this whole trend toward more information and you folks are there to guide them into understanding what makes sense or not.
David Ziegelman: That’s absolutely true. We’re used to, years ago, being the doctor and being more in charge of that sort of thing. It has been very eye-opening to see that, generally speaking, it’s been really helpful to have people have access to things and get results and be engaged with it more. For example, when we made CAT scan results available, one would think that people would be kind of bowled over by it. We give a little bit of a delay and the doctor puts their comments in there, but people really appreciate it. For example, in the future, if they wanted to look up their CAT scan or remind themselves of what their test results are, they’ve got it right there.
UVM Medical Center: Help people understand the process, a little bit, for signing up. It’s pretty easy, right?
David Ziegelman: Yes. Most people sign up when they see their provider. It all comes down to needing a thing called an activation code, which is basically a string of numbers and letters. When you see the doctor and you leave with the paperwork after the visit, on there will be instructions about how to sign up and this activation code. It’s really quite simple. What I do is I just tell people to Google UVM and MyHealth, and it brings you right to the page that you need. It literally asks you what’s your activation code, that’s when you put those numbers in, and what’s your date of birth, and as long as you put those in, now you’re in. You just sign up and that’s it.
UVM Medical Center: For the app, it’s just the basic downloading the app for iPhones and other platforms?
David Ziegelman: Exactly, so once you’re signed up on the website then, for example, with the iPhone, you go to the app store, you actually look for My Chart, not MyHealth Online, because that’s the name that the computer company that we work with, called Epic, has named it. You look for the My Chart app and you download that, you put in your password and you’re ready to roll.
UVM Medical Center: Folks, I have to tell you, it is easy to use and it really has changed, I think, a lot for people in terms of how well informed they feel and the ease of communication with their physicians. It’s all to the good, right?
David Ziegelman: Absolutely. We’re pretty excited about it and we’re looking forward to more and more people signing up and using it.
UVM Medical Center: We’re out of time but, for now, I want to thank my guest, Dr. David Ziegelman. He’s an adult primary care physician at the UVM Medical Center located at 1 Timber Lane in South Burlington, also an assistant professor at the Larner College of Medicine. Thanks very much for being with us.
David Ziegelman: Thanks for having me.
UVM Medical Center: To learn more about MyHealth Online, all you have to do is go to UVMHealth.org/medcenter and, in the upper right corner, you’ll see a box to click on and that’ll give you all the information you need.