Name calling often gets attention, but it rarely solves problems. So when the CEO of the American Medical Association, Dr. James Madara, recently called healthcare IT “the digital snake oil of the early 21st century,” his words were widely reported, though not uniformly praised.
His inflammatory analogy aside, Dr. Madara had a valid point: many physicians are indeed incredibly frustrated with the majority of healthcare IT solutions. What’s more, the usability improvements that Dr. Madara called for are completely reasonable and appropriate.
No other industry on Earth has accepted lower productivity and efficiency as a result of computerization. Do accountants spend more time doing a company’s books using computers than they did by hand? Of course not. Or imagine Netflix subscribers spending twice the amount of time trying to navigate the on-screen interface than it would take to simply pop in a DVD or drive to the local theater. Consumers simply wouldn’t deal with it.
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But that’s the way it is in healthcare. Physicians routinely spend more time doing things on a computer than they used to when all patient records and clinical processes were paper-based. That’s a huge drain on an already over-taxed healthcare system, and especially on physicians, who are healthcare’s most valuable and expensive resource. A new study from the Mayo Clinic reported that the use of electronic health records and computerized physician order entry (CPOE) reduces physician satisfaction and contributes to higher rates of burnout.
The fact is the healthcare industry still is in “version 1” of automating clinical processes, 50 years after the first EHR systems hit the market. Today’s EHRs have gotten rid of paper, which is important, but that’s just table stakes. What they need to do is change the way that doctors do their jobs for the better. Version 2 of healthcare IT must change the paradigm of EHRs, not just the mechanism from paper to electronic.
Take clinical notes, for example. EHRs can legitimately claim to have reduced transcription errors, but overall the computerization of notes has had unintended negative consequences. Electronic notes have become more cluttered and less helpful because most physicians include the last 24 hours of results in their notes — simply because it’s easy to do so with the click of a mouse. Dumping large amounts of clinical information into notes provides little value for the next clinician who reads them. Quite the opposite, in fact – physicians are spending more time sifting through lengthy clinical notes trying to discern the vital nuggets of information necessary to inform the care they’ll deliver to their patients. To date, no one is helping doctors take advantage of the computer to write better notes. And whether in SOAP, APSO, or any other format, the notes taken about a patient’s visit – and, by extension, the system a doctor uses to take them – can impact the patient’s healthcare experience.
Of course moving from paper to computers was a logical and necessary first step. But digitization can be awkward and, in and of itself, doesn’t necessarily yield positive change.
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The healthcare community now needs to rethink clinical processes and workflow and the user experience to begin the next phase: A healthcare system that is optimized for and native to the technology that enables it, as Uber has done with transportation for hire, and Amazon has done with online shopping. That’s where significant benefits will be realized, including (and most importantly) improvements in patient care. And once we achieve technology-enhanced healthcare, healthcare IT will no longer be a target of name-calling.
Photo: Getty Images/Mutlu Kurtbas
Paul Brient is the President and CEO of Patient Keeper. He brings more than 20 years of experience in healthcare information technology including physician workflow automation, physician practice automation, payer-based medical management, pharmaceutical-based disease management and medical devices.
Prior to joining PatientKeeper in 2002, Brient held senior executive-level positions at leading healthcare and consulting firms including McKesson Corporation, HPR, and The Boston Consulting Group. Brient began his healthcare IT career as the founder and president of BCS, an early physician office management software company.
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