A blog about healthcare IT for those who use it

Let’s Cross One Item Off the List of Contributors to Physician Burnout

EHRs are a known contributor to physician burnoutRecently a group of healthcare CEOs co-authored a post in Health Affairs Blog to voice their concerns about the growing problem of physician burnout. It is a complex issue with many causes and implications. The authors of the post write:

“The spike in reported burnout is directly attributable to loss of control over work, increased performance measurement (quality, cost, patient experience), the increasing complexity of medical care, the implementation of electronic health records (EHRs), and profound inefficiencies in the practice environment, all of which have altered workflows and patient interactions.”

The EHR component of the problem is both well documented and particularly unfortunate, as it could have been avoided had healthcare IT innovation been allowed to follow its natural course. In 2008, comprehensive EHR systems were deployed in less than three percent of U.S. hospitals; a greater number had more limited EHRs, but still only about five percent of hospital orders were entered electronically and even fewer notes. The reason for this was simple: the state of the art in healthcare IT was such that it was more efficient for providers to work on paper (frequently in conjunction with a computer) than to work completely in the computer. Users were making a rational set of choices. The 2009 HITECH Act, which added $40 billion in incentives and thousands of pages of often-byzantine legislation, did nothing to improve this, and in many ways made it worse. So now we have “forced adoption” of technology that otherwise would have had to improve dramatically before it would be voluntarily adopted.

Perhaps now, as Meaningful Use winds down, unfettered innovation will lead to what should have come years ago: more physician-friendly systems that make technology an asset, rather than a hindrance, in fostering smoother clinical workflows (and better patient care). Physicians still will feel plenty of pressures, but at least technology won’t add to them.

Where We Are, and Where We Aren’t, in Healthcare IT

From the vantage point of 2017, we can say that at least one objective of the 2009 HITECH legislation – widespread EHR deployment – has been achieved. According to ONC, nearly 96 percent of hospitals have moved to using a certified electronic health record. This is a nine-fold increase in EHR usage since the HITECH Act became law.

However, while healthcare has generally “gone digital,” many in the industry are left wondering, “So what?” Has the technology improved care efficiency, streamlined delivery or improved patient outcomes?

> Read PatientKeeper’s new eBook, “Healthcare IT 2017-2022: First Comes Change, Then Comes Value

Numerous studies say “no.” For instance, according to Deloitte’s 2016 Survey of U.S. Physicians, three out of four physicians believe EHRs increase practice costs, outweighing any efficiency savings, and seven out of 10 think EHRs reduce their productivity.

It’s not all doom and gloom, however. Read more

Putting the “Long” in Long-Term EHR Training

Physicians spend too much time in EHR user trainingWe noticed recently a lengthy blog post by a consultant, offering advice to hospitals that use a popular EHR system about how to structure a successful user training program. The post ran over 1,100 words. No doubt the article offered sound, best practices guidance to those hospitals. Still, it left us wondering: If it takes this long just to outline the basic parameters of an EHR training program, how complex must the training program development and administration be? Moreover, how long must the training itself be?

Our conclusion: Way too complex, and far too long. Read more

Are We There Yet?

PatientKeeper eBook: Healthcare IT 2012-2017: First Comes Change, Then Comes ValueSooner or later, the question nearly every parent hears whined from the back of the car is, “Are we there yet?”

Physicians, saddled with convoluted EHR systems that impede their productivity and intrude on patient care, can be forgiven for asking the same question about healthcare digitization. Already it has been a long ride. The answer to them is, “No. Not nearly. Not yet.”

Why aren’t we doing better at fulfilling the promise of healthcare digitization and realizing a return on the nation’s massive health IT investment? There are several parts to that answer. Read more

Off to Orlando

PatientKeeper will exhibit at HIMSS17 booth #2333Next week at HIMSS17 in Orlando, PatientKeeper is excited to offer the healthcare industry a sneak peek at our forthcoming “innovation platform” – technology intended to advance the use of computers by physicians and care teams, and make them indispensable tools for 21st century clinical care. Our goal is ambitious: to transform healthcare IT into an accelerator of effective inpatient care, rather than the encumbrance that many physicians view their EHRs as today.

This is no small task. PatientKeeper’s new platform integrates third-party apps and data from multiple EHRs, embeds advanced clinical decision support (CDS) capabilities in a truly useful way, and provides an individualized experience for each user. We will illustrate the capabilities and versatility of our innovation platform through a range of demonstrations. Please stop by our booth (#2333) to see them. Read more

Tick, Tock Goes the Clock

Most of the software applications office workers use in business every day are second nature by now; many people have been using them for years, perhaps decades. In fact, it’s hard to remember when these applications were new and users had to receive formal training on them.

Not so in the world of healthcare, however. Physicians are saddled with using EHR systems that in many cases require considerable training.

What if every week you had to attend a lengthy training class for one office system or another? Imagine how that would hamper your productivity.

If office software was like EHRs, users would need extensive training just to write a memo or send an email

 

 

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Physicians, as avid users of mobile devices and self-evident apps, have no more patience for non-intuitive software than anybody else would. More importantly, when doctors are in IT training classes, they are not doing what they should be doing: caring for patients.

The era of complex EHRs that require massive investments of time and money in physician training needs to end, and soon.

See previous entries in our “What If” animation series.

Say What?

Every industry has its unique jargon and acronyms. Business people are used to it. But what if whenever you wrote an email you were forced to communicate with unfamiliar codes instead of words?

All businesses have their jargon, but nothing as obscure as the ICD-10 codes physicians have to use

 

 

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This is a daily challenge for doctors who are required to use arcane ICD-10 codes – there are nearly 70,000 of them – when recording their patients’ diagnoses in their clinical notes and charges. Fortunately, every physician doesn’t have to memorize all 70,000 codes; specialists may only use several dozen routinely. More fortunately, technology exists that allows physicians to use familiar medical terminology in their notes and charges, which the computer then automatically translates into the appropriate codes.

Even so, American office workers should be grateful that their business communications are conducted in English rather than in code.

See previous entries in our “What If” animation series.

Over and Out

Collaboration among workers is expected and necessary in most business offices. Colleagues collaborate every day to advance their work through well-established business processes; it is standard operating procedure.

Collaboration also is required to deliver high-quality medical care; indeed, effective communication among members of a patient’s care team is essential.  However, quickly comprehending each patient’s medical condition and treatment plan is a daily challenge for doctors in hospitals during hand-offs between providers.

To appreciate the physician’s problem, what if every morning as you walked into the office you received a large stack of someone else’s work from the previous shift to decipher and handle?

What if every morning as you walked into the office you received a large stack of someone else’s work from the previous shift to decipher and handle?

 

 

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The potential for confusion is great when too much information is communicated, or the information is poorly organized. For doctors using hospital EHR systems, the problem can be more than an inconvenience; it can affect decisions about a patient’s clinical care. Which is why intuitive documentation and sign-out tools are so important for physicians in a hospital setting.

See previous entries in our “What If” animation series.

Notemares

Most of us learned to take notes in school when we were kids, and it’s a practice we carried forward into our business lives. Note-taking styles vary widely — some people scribe every word of a meeting, while others jot down a thought or phrase to jog their memory afterward.

But what if you were required to write down every interaction you had with your boss or co-worker as you went about your day?

Notes are a daily challenge for doctors and other clinicians, who must continually record all of their patient care actions

 

 

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Notes are a daily challenge for doctors and other clinicians, who must continually record all of their patient care actions. (This is because clinical notes facilitate generation of a bill and they document providers’ assessments, actions, and plans to treat patients, in order to ensure clear communication with all members of the patient’s care team.)

Unfortunately for healthcare providers, EHR systems frequently make clinical notes less comprehensible, not more, partly because too much historical data gets crammed into notes – just because it’s there and easy to include.  The industry at large and health IT vendors in particular still have a lot of work to do to streamline clinical documentation and end physicians’ notemares.

See previous entries in our “What If” animation series.

When Will Interoperability Be a “Given” in Health IT?

Fortunately, basic interoperability among general office systems was achieved long ago. It is now hard to imagine not being able to exchange emails or documents easily with a colleague inside or outside your organization.

But what if you could not successfully send an email, note or even conduct a quick phone call with someone in another office because your systems were technically incompatible? This is a daily challenge and frustration for physicians, many of whom to this day are unable to share information between hospitals and health practices due to a lack of interoperability among EHR systems. It looks and feels a bit like this:

Lack of interoperability among EHRs poses a problem for physicians trying to get complete patient data

 

 

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With some prodding from the government, health IT vendors now are working to resolve this thorny problem. Of course, PatientKeeper has long had a core competency in integration, so users of our systems have always been able to access and act on patient information from a wide array of EHRs and departmental systems. Just as office workers don’t give interoperability a second thought, physicians and other clinicians shouldn’t have to, either.

See previous entries in our “What If” animation series.