Informed Consent: Let Go of the Status Quo

Posted on October 1, 2018 I Written By

The following is a guest blog post by Shahid Shah.

We’ve all heard it before: “healthcare is slow to adopt new technologies.” In fact, we’ve heard it so many times that we just accept it as gospel and don’t give it much thought.

It’s not true though.

For example, I remember when the iPhone was first released, it was easily adopted by doctors because it gave them something they craved: increased freedom by having access to information on the go.

What’s probably true is that “healthcare institutions are slow to adopt new technologies that impact status quo.

Why is that?

Because the perceived cost of maintaining the status quo is smaller than the cost of the innovation (e.g. product or solution), even if that innovation is free.

When the cost of not doing something new is low, nothing will change: and bad leadership is often able to keep the cost of maintaining status quo very low. Poor leaders add hurdles, like requiring unknowable ROI analyses, for introducing innovation but don’t penalize maintenance of status quo. This means that it’s easier to not introduce anything new – because the cost of not innovating is low but the cost of innovating is high.

Let’s take a look at digital patient consent as an example of an innovation – obtaining patient consent to perform a healthcare service is something that no hospital can do without. Called “informed consent”, this is a document that patients are required to sign before any procedure or health service is delivered. You’d think that because this form is the initial and primary document before almost any other workflow is started, that it would be the first to be digitized and turned into an electronic document.

Unfortunately, it’s 2018 and informed consent documents remain on paper. Thus:

  • JAMA reports that two-thirds of procedures have missing consent forms
  • JAMA reports that missing consent forms cause 10% of procedures to be delayed, costing hospitals over $500k per year
  • Joint Commission reports over 500 organizations annually experience compliance issues because of missing consent forms. There’s almost a 1 in 4 chance that your own organization has this compliance problem.
  • A recent JAMA Surgery paper estimated that two thirds of malpractice cases cited lack of informed consent, which increases liability risk
  • Superfluous paperwork directly contributes to clinician burnout
  • Patients often don’t understand their procedures or aren’t properly educated about the service they’re about to use

Today, many healthcare institutions go without automation of consent documents – which I’m calling the status quo. Even though this document is essential, and its non-digital status quo creates many financial, clinician, and compliance burdens, it’s not high in the list of priorities for digitization or automation.

As I enter my third decade as a health IT architect, after having built dozens of solutions in the space that are used by thousands of people, I still find it difficult to explain why even something as simple as an informed consent isn’t prioritized for automation.

It’s not because solutions aren’t out there – for example, FormFast’s eConsent is a universally applicable, easy to deploy, and easy to use software package with a fairly rapid return on investment. With eConsent software, clinicians aren’t interrupted in their workflows, patients are more satisfied, compliance becomes almost guaranteed, and procedures aren’t delayed because of lost paperwork.

A senior network engineer at East Alabama Medical Center recently wrote “the comparison of creating a form in the EHR vs. an eForms platform? There is no comparison. We are saving thousands of dollars by using eForms technology and the form creation is simple.”

Why do you think even something essential like patient consent forms remain on paper? Drop us a line below and let us know why the status quo is so powerful and what’s keeping your organization from adopting electronic forms solutions.

Note: FormFast is a proud sponsor of Healthcare Scene.