When I first met with Stoltenberg Consulting a few years back at CHIME, they said something really interesting that I’m still thinking about today. In fact, I might be thinking about this more today than I was doing before.
Per my notes (so I won’t make it a direct quote), they commented that doctors were putting a lot into the EHR, but they don’t feel like they’re getting a lot out of the EHR.
It’s a powerful idea that is really important for any hospital executive to understand.
I recently wrote about the choice between the Best-of-Breed EHR and the All-In-One EHR approaches on EMR and HIPAA. Here’s the money section:
The real decision these organizations are making is whether they want to put the burden on the IT staff (ie. supporting multiple EHRs) or whether they want to put the burden on the doctors (ie. using an EHR that doesn’t meet their needs). In large organizations, it seems that they’re making the decision to put the burden on the doctors as opposed to the IT staff. Although, I don’t think many organizations realize that this is the choice they’re making.
Choice of EHR is only one of the main reasons why doctors likely feel that they’re getting less out of the EHR than they’re putting into it. Certainly reimbursement requirements and meaningful use should still take a lot of the blame as well. Regardless of how we got here, it’s a very precarious position when the doctors feel like they’re getting less out of the EHR than they are putting into it.
There is a solution to this problem. First, you must work to maximize the physician workflow. Sometimes this means involving the nursing staff more. Sometimes this involves a scribe. Other times it requires a change to your EHR. Other times it means building out high quality templates that make the doctor more efficient.
Second, we must all focus on more ways doctors can get more value out of their EHR. The buzzword analytics has potential, but has been a little too much buzz word and not enough practical improvement for the doctor and patient. We need more advanced tools that leverage all the data a doctor’s putting in the EHR. Clinical Decision Support, Drug to Drug and Drug to Allergy checking are just the first steps. We can do so much more, but unfortunately we’ve been too distracted by government regulation to deal with them. Plus, let’s not kid around. These aren’t easy problems to solve. They take time and effort. Plus, we need a better way for doctors and hospitals to be able to diffuse their discoveries across the entire healthcare community. Sharing these discoveries is just too hard and too slow right now.
At the end of the day, it’s a simple scale. On the one side you have the time and effort a doctor puts into the EHR. On the other side is the value the doctor gets from the EHR. You can solve this by making the doctor’s EHR work more efficient or by finding more ways the EHR can provide value to the doctor. Much easier said than done. However, if this stays out of balance too long, you can count on a big EHR backlash from doctors.