5 ways health care IT must improve

Health care information technology has of course grown exponentially over the last decade, as electronic medical records (EMRs) and computerized physician order entry (CPOE) systems have become ubiquitous. It’s funny to think that not so long ago, physicians and nurses had to trawl through piles and piles of paper charts to search for the information we needed — whether it was lab results or patients’ notes.

However, the road to this electronic environment has not been entirely smooth when it comes to  implementing the technology in hospitals. There have been lots of bumps along the way as health care organizations have rushed to comply with meaningful use requirements in order to receive much needed federal incentives. Ironically, because of the time and effort that it takes to learn new systems, many EMRs and CPOEs have inadvertently impaired patient care to a certain degree. And due to the suboptimal nature of many of these systems, these problems have persisted well beyond their “launch”, no matter how noble the initial goals were.

Here are 5 ways that health care IT must improve as we look towards the future:

1. Make systems more efficient. Entering data and orders is still too cumbersome, and needs to be made much more user-friendly. Get rid of the mouse, utilize touch screens and have minimal clicking to get what you need. Ordering something as simple as a Tylenol should not take a dozen or so clicks and several seconds of typing, as it frequently does.

2.Integrate different EMRs together. Different hospitals and primary care clinics typically use different systems, presenting significant logistical difficulties for doctors to get the information we need. There has to be a better way of bringing everything together.

3. Make everything mobile. Just like we can walk around our house with our tablet computers, doctors and nurses should be able to do the same in the hospital. Yet we are still largely restricted to our desk and PC. Using a mobile “cart” is no better, and it’s far from ideal to be pushing around heavy equipment in today’s technological age.

4. Start using voice recognition. Wouldn’t it be great to be able to just speak out our orders into a handheld device, just like we can talk to Siri on our iPhones? How much time would this save at the frontlines? Similar to how we frequently dictate our notes now, it should be just as easy for entering orders.

5. Recognize the limitations of IT and understand that health care is a human experience. While technology is wonderful, it does have limitations. The world of IT has to understand that the field should be used as an aid, working side by side with doctors and nurses. It isn’t, and never will be, a substitute for human contact. If we’re talking about patient satisfaction and improving the health care experience, nothing trumps good solid medicine in a compassionate and caring environment.

The next few years will be pivotal in determining the type of health care we value and want for future generations. It will also determine the role of the doctor in this new medical age. It’s vital that health care IT is not only made better, but also used in the right way. Only by all parties working together — doctors, nurses, IT professionals, entrepreneurs, and even the government — will we ensure a brighter future for our patients.

Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being.  He blogs at his self-titled site, Suneel Dhand.

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  • W. X. Wall

    While your prescriptions are reasonable, IMHO, your error is in assuming that EMRs are designed to improve patient care. EMRs, like any other product, are tailored to the needs of the people that buy them. In this case, that means administrators. While physicians may make purchasing decisions in their outpatient offices or group settings, the truly gargantuan systems are based on selling a hospital CEO, not the front-line clinicians. To the extent that front-line clinicians are discussed at all, it’s to figure out ways to “encourage” physicians to along, assuming that physicians who deal with complexity and high tech on a daily basis are somehow luddites while CEOs who can’t figure out their blackberrys and print out email to have their secretaries type out responses are forward thinkers equivalent to Isaac Asimov.

    So what do administrators want? Improved billing, decreased liability risk, and increased control over a traditionally independent medical staff, probably in that order. Quality of care is far down the list and regardless, is measured by things like patient satisfaction surveys and meeting Medicare checklists which, again, EMRs are great for.

    So when you say health care IT must improve, the question is, for whom? For the ones that choose the systems and therefore have actual power over EMR companies, EMRs are working swimmingly well, and continue to “improve”.

    • Eric Strong

      Agree. In a recent survey of 18000+ physicians about their EHR, the VA’s license-free EHR, Vista (a.k.a. CPRS) had the highest overall score. (http://www.medscape.com/features/slideshow/public/ehr2014)

      The interesting thing about that, is that since neither VA physicians nor the VA as whole bills insurance companies, at least not in a conventional way, the EHR is not focused on billing, and is therefore more provider-focused than other systems.

  • James O’Brien, M.D.

    If it’s really for the patient, the solution is simple…an encrypted thumb drive…medical information on the cloud is eventually going to be public.

    I cannot believe there is not more concern about this Orwellian state of affairs.

  • meyati

    OK, I got a USB medic alert. The ambulance crews and PCs in the clinics don’t even have a USB port. The medical system is worried that the janitor or somebody will use jump-thumb-flash drive to steal something from the PC. Or maybe be really cheap—in buying PCs.

  • James O’Brien, M.D.

    IT today is what automotive repair was forty years ago…a scam to get people to overpay for often unnecessary services…

    http://www.nationaljournal.com/health-care/obamacare-website-has-cost-840-million-20140730

    There are a lot of con men out there…beware

  • rbthe4th2

    Oh no not #4. Good Lord. I had that old doc of mine do voice and I had to spend WAY too much time doing HIPAA modifications. You won’t believe some of that stuff. Ye Gods no …

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