No industry has ever computerized its operations with the goal of reducing productivity and efficiency; that would be absurd. Yet we see countless articles and complaints from health care professionals about the fact that certain systems, especially electronic health records (EHRs), have made physicians less productive, less efficient, and potentially less effective. If computers performed similarly for knowledge workers in other industries, they’d still use paper.
While an EHR is supposed to “automate and streamline the clinician’s workflow,” most systems are not living up to the promise. Counterintuitive workflow, extensive training and alert fatigue are just a few of the hurdles care providers must jump over when going about their daily tasks. These challenges among many others can hinder patients from receiving the best possible care.
In this slideshow, PatientKeeper, a leading provider of health care applications for physicians, shares six reasons why IT is contributing to health care inefficiencies and what can be done to rectify the problems.
Tackling Health Care Tech Inefficiencies
Click through for six reasons IT is contributing to health care inefficiencies and how the problems can be corrected, as identified by PatientKeeper.
Hospital EHRs impose an unfamiliar workflow on physicians, dictated not by what the physician knows about treating patients (and has been doing for years), but rather by the processes that exist deep inside the hospital. If technology was designed with more input from physicians, providers’ workflows would be more intuitive, more personalized, and would more easily fit into their specific work style. Tailoring the user experience would allow providers to review their patient lists and charts in the most convenient way.
Typical hospital EHRs require extensive classroom training that often takes physicians away from their patients for days at a time. If anything demonstrates how non-intuitive most EHRs are, it’s the training required to use them. As the chief executive of the physicians group at Mass General Hospital, speaking about its new EHR, recently told the Boston Globe, “It’s not an intuitive program, it’s incredibly complex. Not everything is Uber or OpenTable.” This reality speaks to the value of purpose-built systems designed specifically for physicians, with extensive input from physicians that can integrate with a broad-based EHR. Systems developed in this way would likely be more intuitive and would make lengthy training a thing of the past.
Physicians waste a lot of time clicking around the hospital EHR to find all the information they need about a particular patient. That’s because the data may live in multiple systems/modules, and the systems are structured in a process-centric way rather than a patient-centric way. By providing physicians with tools to easily find the information they need instead of shackling them to outdated processes, they can become better problem solvers and spend more time delivering high-quality patient care.
Many alerts issued by computerized physician order entry (CPOE) systems are unnecessary or irrelevant, and fail to take into account the physician’s specialty, knowledge and patient situation. As a result, physicians no longer pay attention to them. This can lead to relevant, perhaps critical, alerts being missed, putting patients at risk and defeating one of the main purposes of CPOE. By streamlining alerts and tailoring them to each physician, hospitals will more consistently put CPOE technology to its intended use and support patient safety goals.
Many computer systems make it easy and seemingly encourage physicians to dump large amounts of clinical information into progress notes, providing little value for the next clinician who reads them. As a result, physicians are spending more time sifting through lengthy clinical documentation trying to discern the vital nuggets of information necessary to inform their care decision making. In order to combat this bloat, documentation software design should include customized note types, quick text, and integrated links to clinical data, all of which (used properly) can help physicians to create more meaningful and valuable documents.
The lack of interoperability among health IT systems has been in the news a lot recently. It was spotlighted at the annual HIMSS conference in March, where HHS Secretary Sylvia Burwell announced the national interoperability pledge; and it was raised again by Vice President Joe Biden at the Health Datapalooza in Washington in May. Clearly, the push for standards to facilitate data interoperability in health IT is in high gear. Even as that effort progresses, vendors and provider organizations must continue to prioritize system integration to ensure that within a hospital or an IDN there is a smooth flow of clinical information that physicians need in order to provide the best patient care possible.