Usually, patients remain unaware of the demands health care technology makes on the time and attention of physicians. The patient may sense the doctor is always rushing and perhaps not spending as much time with them as they would like, but they don’t realize that the computerization of the medical office is part of the reason why.
Health care providers, for their part, may feel the reliance on computer platforms has become excessive—a phenomenon I call over-tech. They may think, “Is all this technology helping me?” Health IT has become a kind of background noise in the practice of medicine, one that is often annoying and disruptive to performance. What happened?
We wanted to replace paper.
Electronic medical records (EMRs) and electronic health records (EHRs) have been around for a long time. Originally, they were just computerized replacements of the paper documents used to keep track of patient care.
As paper records transitioned to computer databases, demands placed on the patient chart increased. For example, insurance payers realized that computerized records strengthened their ability to ensure doctors asked patients specific questions and documented the answers.
Administration eclipsed patient care.
As the process of computerizing ambulatory care unfolded, more thought was given to the administrative demands of health care delivery than to the needs of people who actually care for patients. We try to remedy this by developing computer systems and records designed by clinicians for clinicians. We try to harness technology to automate routine administrative tasks.
But the problem goes deeper. Medicine is highly regulated; many government entities have a say over health care, and each wants care delivered or compensated in a certain way. While these entities may have the interest of the public and patients at heart, they contribute to the administrative burden felt by physicians. Next, toss in insurance companies—whose policies often pressure doctors to try to see as many patients as possible.
What to do?
So what can health care providers do to turn down the noise?
Make sure you select the right platform. My advice to medical practices: First, select the right health IT platform for your practice. One that makes getting the information you need to practice and document care as easy as possible.
That the system should make it easy to chart care during an in-person visit is taken for granted. Consider, however, that you may need records from a hospital by the patient the week before—that’s a different computer system. You may need records from their previous doctor—that’s a different computer system, or maybe it wasn’t even computerized. Look for a system that can obtain and integrate these records and, when possible, bring information to you automatically and even organize it for you.
Get to know your EHR. It continually surprises me that medical practices often don’t grasp the importance of a solid understanding of the EHR system they use daily. Whether or not you like computers, as a doctor, you use these things 6, 8, 10, or 12 hours a day. Do as much as you can to understand how the system works and how to use it efficiently.
Talk to your EHR vendor, talk to peers who share the same vendor, and go to user conferences. Learn as much about the system as you can. Love it or hate it, the more you know about your EHR, the more efficiently you can use it. Hopefully, you’ll find it less burdensome and more helpful when caring for patients.
Use your voice. Voice recognition technology gives us the ability to decode the human voice. It’s increasingly popular for everyday consumers—think of smart assistants such as Amazon Alexa, Siri, Echo, and Google Assistant. It will be increasingly important for providers who will find opportunities to use this technology to ease their documentation burden.
Get on board with mobile. Mobile devices are getting better, faster, and more powerful. You may be pleasantly surprised by how many administrative tasks you can tackle with your smartphone or tablet and how much faster and easier it is than the desktop EHR.
Lower your administrative burden
The goal: Turn down the noise that emanates from computer systems in the medical office and the multitude of systems in the health care space that don’t do a good job of talking to one another. Get on board now.
Robert Murry is chief medical officer, NextGen Healthcare. He brings to this position more than 20 years of extensive clinical experience and background in health IT. Previously, Dr. Murry served as the company’s chief medical information officer (CMIO) since May 2017. During his time as CMIO, he was the “voice of the physician” across specialties, product safety, and government/regulatory affairs. Before becoming CMIO, he was the company’s vice president of clinical product management, responsible for clinical oversight and workflow design.