Who owns the patient narrative anyway?

An emerging trend in health care is the concept of a patient "narrative" — the "story" that makes up a patient's history, diagnosis and prognosis.

The problem is how to give a patient the chance to tell their story, in her or his own way, when the provider only has eight to 10 minutes before moving on to the next patient.

Currently it's a game of deduction — the provider asks pointed questions and gets to the best answer as quickly as possible. But that's not satisfying to either patient or provider.

Maybe there's a better way.

A recent Twitter chat about health care social media (#hcsm) revealed a great opportunity to collaborate on the patient narrative. From Kathy Nieder, MD, a family physician at Baptist Medical Associates in Louisville, Ky.:

T3 I want to learn how to better chart patient narratives in the #EHR, I'm listening better thx to #hcsm, but documenting is difficult #hcsm

— Kathy Nieder MD (@docnieder) January 6, 2014

My response:

@docnieder And perhaps finding ways to have patients collaborate on that narrative! #hcsm

— Jim Rattray (@jimrattray) January 6, 2014

This followed on a similar discussion about whether the term "patient" has run its course and should be retired and replaced with something new. Suggestions ranged from "person" to "colleague."

The ultimate goal of patient engagement is collaboration and understanding — building a partnership between patient and provider where dialogue replaces monologue.

As EHRs (electronic health records) mature, the next step needs to be smart interfaces that allow patients to tell their stories, in their own words and their own way, and have the EHR "translate" that into meaningful and actionable information for the provider.

Such a system would not only provide a greater level of satisfaction for patients, but give providers a more complete picture of their patients.