Freek Kinkelaar, Kees van Boven and Annemarie Uijen

David Bowie sang it all in his hit Fame in 1972: “Fame, makes a man take things over.”

And rightly so. Patients have control over their own care process when possible. The FaMe (Family Medicine) app was developed in Nijmegen and is an important tool. Access to your own GP file, anytime, anywhere. It’s possible!

In 1995 the Law on Medical Treatment Agreement (WBGO) stated that a patient the has the right to inspect their own medical record. In practice, patients rarely make use of this right. This is mainly because it often takes a long time before a paper printout is available or until the patient can see the file at the doctor’s office. Time for improvement, said Kees van Boven, Annemarie Uijen and Henk Schers, all GPs and researchers at the Medical School Center for Primary Care at the Radboud University Nijmegen. In recent months they worked hard on FaMe: the app that allows patients online access to their own GP file.

The use of mobile devices, phones and iPads, has boomed in recent years. Also in healthcare digitazation has been growing steadily. If you mix these developments with a person-oriented approach and the idea that the patient should be at the center of their own care process, you get FaMe. By giving patients an active role in the care process, they are likely to take more responsibility for their own behavior and health. Earlier research among 105 GPs and over 13,000 patients shows that online access to the GP file leads patients to feel more control over their care and are more complient with their treatment. Only  in 1-8% of cases acces to the file confused, worried or insulted the patient. An often-heard fear among GPs is that through access to the GP file the contact with the patient takes longer because they have to answer questions about the file. However, in practice only 0-8% of GPs reported that the contact lasted longer. After one year gave 99% of patients and 100% of GPs wanted to continue with the online access.

FaMe in practice

What does online access to the GP file mean? The FaMe app provides patients access to information about their own conditions, medication use, laboratory tests, measurements (height, weight, BMI, blood pressure, pulse, alcohol consumption and smoking), intolerances, contraindications, letters from primary care providers and specialists and the policy set by the GP during encounters. It is very practical for patients when they can review their own file for example during a visit to their GP in the evening / night / weekend or during a visit to a specialist. Thanks to the FaMe app patients always have access to their GP record.

In addition to online access to the data that the GP provides, patients themselves can also add data to their record through the FaMe app. They can enter blood pressure values, glucose measurements, and their weight and height. This is especially interesting for people with diabetes and patients with cardiovascular risk.

Furthermore, patients can easily make appointments for consultation with the GP through the FaMe app. This can save the both the patients and the practice a valuable amount of time.

Lastly, FaMe provides information about the GP practice and links to patient information websites such as that of the Dutch College of General Practitioners.

Developed for TransHis

The FaMe app is primarily designed for practitioners who use TransHIS as their GP Information System (HIS). The TransHis practices, located in Amstelveen, Franeker, Academic Health Thermion in Lent, University Health Heyendael in Nijmegen, Olst and Oosterhout (GLD), together with the Radboud University Nijmegen Medical Centre form the primary care network FaMe-Net (Family Medicine Network). The FaMe app is available on mobile phone and tablets. Although it is technically possible to develop FaMe for other GP information systems, developers are concentrating on TransHis.

The privacy of the patient

Much attention in the development of FaMe was given to the privacy of the user. In order to protect their privacy, patients must log in with their Citizen Service Number (BSN), a GP office code and a unique PIN. This GP office code and PIN are given to patients when they can identify themselves at the GP’s office. The patients are in charge of who who gets access to their own GP file and, very importantly, what data they can view. This is an essential difference with the Electronic Patient Dossier (EPD), in which patients opts to authorize access to their medical record to each provider for an indefinite period.

Evaluation and future

Over the next few months, the FaMe app will be scientifically evaluated by patients, GPs, GP nurses and GP assistants. By means of questionnaires and interviews the experiences of the users are being investigated. After the evaluation period and possibly after some changes, the FaMe app will be made available to all patients registered with GP practices that use TransHis, starting early 2015.

The possibilities of FaMe in the future are intriguing: e-consulting, patients entering body function measurements, online surveys for medical research, or connecting FaMe to the Radboud University Medical Center’s web service. The Radboud University Medical Center has been providing patients with the opportunity to register online and review their medical records. Research has shown that there is high satisfaction among both patients and doctors.

Digital innovations in patient care, where patient-centered and person-centered care is paramount, are the future. FaMe is one of those innovations. Via this Lijn 1 (a medical magazine for GPs), we like to keep you informed about the results of the research and the developments surrounding the introduction of FaMe in GP practices.

References

  1. Delbanco T, Walker J, Bell SK, Darer JD, Elmore JG, Farag N et al. Inviting patients to read their doctor’s notes: a quasi-experimental study and a look ahead. Ann Intern Med 2012;157:461-470.
  2. Kremer J, Leather R, L Haszing, Samsom M. Online access works in its own file. Medisch Contact 2013; 47: 2475-2477