When my doctor walks In the exam room, I want him to pay attention to me and not to the computer. Not only is this what all patients want, but it is also what doctors want. Yet today there is pressure on doctors to feed digital animals.
Latest health care Best-selling MD author, Bob WatcherSays that a single doctor can record 4,000 clicks in a 10-hour shift. Even worse, the majority of this activity is the regular census, run by insurers and regulators who consider digitization to make it easier to collect statistical data, even if it contributes to quality of care.
Doctors are not laddus. Many were initially enthusiastic about automating their behavior, expecting the same applicability and productivity with which, they say, the software they use to do their taxes. The expectation was that the software would be at least as good for medical professionals. The reality is that the more “digital” practitioners go, and the longer they use the software, the more satisfied they become.
This is the kicker: Health care is the only industry that has managed to lose productivity going digital.
Typical electronic medical record software is a circle of tabs and dialog boxes that doctors must navigate to record the same information they were able to use with some notes in a file folder. And what do they get for their effort? Sadly, consumer apps are better than helpful information and unexpected insights.
The software problem of healthcare will not be solved with a user interface overhaul – EMRs need to be smarter, not just pretenders. Think network, not software alone. We need to bring together the intelligence of doctors, nurses, patients, hospitals, laboratories, insurers and all others who contribute to the continuity of care.
A lot of doctors care in disconnected software that doesn’t know if the patient had an adverse reaction to the drug, saw a different doctor down the road last week for a related element, or years for similar symptoms. Have done countless tests. Expecting intelligence from the isolated EMR will start playing your CD player Isaac Hayes because you like James Brown. Unlike your favorite digital music service, it’s not just wired that way.
For the last four years, my company, Athenahealth, has been working to reintegrate EMR. We want to get the problem out of technology so that it is useful for the physician and comfortable for the patient. We are not making, but we are making progress. Finally, we focus on delivering EMRs that provide rich clinical information, while still allowing doctors to be fully present in meaningful moments of care. In other words, we believe that technology should allow doctors to be doctors.
In our quest to make EMR smart, our primary strategy is to simplify every procedure, where physicians are given a large number of options. Because we operate a network, serving more than 67,000 providers, more than 69 million patients, plugged in, we can collect what we learn from every conversation. This is on the order of 330 million data exchanges per month. We are studying health care in the wild, as well as listening to doctors and care workers.
Complexity is the enemy. Medicine is necessarily complex, but the administrative complexity surrounding it can be reduced. For more than 15 years, we have managed the Byzantine world of reimbursement to help providers pay faster. Recently, we have been implementing the same discipline to make electronic health records more useful. Our goal is to motivate providers to gather the data they need to gather in the least intrusive way possible.
Wherever possible, delegation should range from doctors to nurses and administrative staff and even patients. Instead of patients answering a whole series of routine questions with their knees in the exam room, give it to them on a mobile app from home the night before. If a physician is prescribing a prescription for a diabetic patient rather than presenting it with all possible medications, then why the EMR surface may not be the most appropriate ones based on a doctor’s previous options, but also What is trending and usage based on throughout the network?
If we expect information technology to help us achieve a more efficient, more effective, higher quality health care system, we not only need to collect data efficiently, but make sure we learn from it and care Translate into meaningful moments.
We need to make EMRs service providers, rather than the other way around.
So we are starting a social engagement campaign Let doctors be doctors. We are hoping that everyone in the provider community believes that there is a better way, share your EMR stories and recommendations letdoctorsbedoctors.com. We will help Washington develop a health IT policy initiative to help bring that response, which currently includes legislative efforts to improve the differential and utility of EMR.