Is Gassing Up the Car the Highlight of a Family Vacation?
Physicians love medicine, but not all individual components of medical practice are inherently fulfilling. As in any profession, there are some things that are just tasks, and nothing more. These are the things that wear on a physician, the things that make it hard to be a doctor, and among the most notable of these tasks is the repetitive process of sitting down (or even standing at the desk) writing orders for our patients.
It’s like filling up your car at the gas station, repeatedly, as you drive across country on an adventurous family vacation. It’s a necessary task, as writing orders is for a physician, but neither is seen as the “highlight” of the day – and if either task disappeared, never to be seen again, no one would miss it. In both instances, the goal typically is to shorten the time it takes to complete the task and return to the primary objective as quickly as possible.
Which goes a long way toward explaining why traditional CPOE has been so poorly received by most physicians. To date, CPOE systems (for a variety of reasons) have slowed physicians down. That’s a step in the wrong direction. So this is what physicians hear when ONC promulgates Meaningful Use standards around CPOE:
“We mandate that, as of tomorrow, this task that you never really enjoyed doing, and have always done in a particular way, must now be done in a new and totally different way; and this new way is going to change your workflow, lower your productivity, and cost you money.”
Needless to say, this is not a compelling “value proposition” for physicians. So our initial response has been to resist the mandate for change, and resent those who have proposed it. Many physicians have become indignant with respect to CPOE, and often feel burdened by the mere notion of using it in our practices. Something, however, has to be done about this stance we have taken, as too many physicians feel this way, and failure to adopt CPOE is not an option.
We are beginning to see the solution, I believe, in new CPOE software that is designed with physician workflow in mind, that actually speeds up the ordering process, and that provides options, flexibility and clinical support that physicians appreciate. All of these things serve to create a physician-friendly, time-saving environment, one that is rich in clinical data, and primed to help doctors make the best choices for their patients. This new CPOE may represent a departure from ordering practices of the past, and the way things were when I trained over 20 years ago – but this is a change for the better, and our patients will be safer for it.