Advancements in health IT have created ease and efficiency in delivering health care that has never been seen before. Electronic ordering and prescribing have reduced medication errors from misinterpreting handwritten information. The interoperable transmission of critical patient history, lab work, and digital imaging from one hospital to another has reduced costs and unnecessary extraneous tests. Virtual care and telehealth utilization during the COVID-19 pandemic has revolutionized how patient encounters are performed and are becoming a standard of health delivery. The digital collection, aggregation, and analysis of population health data provides new insights into social determinants of health that can be used to understand better and improve our communities. Meanwhile, advances in machine learning and artificial intelligence represent exciting new frontiers in future medicine.
As a recent graduate from residency, I have experienced and integrated these technological tools into my practice. I embrace any innovation that can enhance the patient and provider experience. With that said, in this portion of the essay, I become a curmudgeon surgeon and lament one of the greatest downfalls I have seen with the rise of new technologies – the decline of direct communication between providers.
Direct person-to-person communication has always been an essential component of patient care delivery. Communication exists between two colleagues discussing a patient’s complex management; between a primary provider and a consulting specialist; between provider and nurse; and between provider and patient. The ease of new technology has obviated many needs for direct communication, and I believe that is a detriment to medicine.
In my few years of practice, I have noticed an increasing lack of communication in health care. Consulting providers and multi-disciplinary teams caring for a single patient can find themselves communicating with one another through electronic charting. These messages would not be read until the next time a provider opens the chart and combs through each new note. Often, critical messages and information become diluted within a note, resulting in delays in care.
Transferring medical records from one facility to another can result in critical information being hidden within hundreds of scanned document pages. Nurses will send electronic messages about declining patient vital signs that become unread. Physicians will order something STAT, yet that order gets unacknowledged. There are just a few of the countless examples of technology intending to improve patient care communication, however, having unintended consequences of impeding it. In many of the described situations, something as simple as a phone call between providers could have expedited and prevented patient care delays. It may not have a fancy user interface, but a phone call is often the most direct and efficient way to communicate information.
Innovations in health technology will continue. However, we must recognize that it cannot replace poor communication between providers. Health IT tools must not supplant provider-to-provider communication but augment and enhance it.
Juan Pablo Zhenlio is a general surgeon.