Physician Leadership and Clinical Redesign: The Future All Over Again

Physician Leadership and Clinical Redesign: The Future All Over Again
Dr. Andrew Agwunobi

Guest post by Dr. Andrew Agwunobi, leader of the hospital performance improvement practice at Berkeley Research Group.

Four healthcare reform elements are driving hospital systems to recreate themselves through buying physician groups, attempting to dramatically improve the quality and costs of care, and merging with other hospital systems. These are 1) the new Medicare readmissions payment policy, 2) the Medicare and Medicaid payment bundling pilots, 3) Medicare’s decision to stop paying for hospital acquired conditions, and 4) the American Recovery and Reinvestment Act of 2009 (ARRA). 

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No Surprise Here, Physicians Use Healthcare Technology Less than Others in the Practice Setting

If physicians use healthcare technology so much less than practice administrators and others in the average practice with these implemented systems, why do they continue to receive so much of the marketing and pre-sales attention from vendors and others in HIT community?

All healthcare vendors take a similar approach with physicians as they jostle for a lane at the front of the race. They gear their public-facing collateral and educational materials to physicians knowing all the while that they also must woo practice administrators and support staff. Rarely, though, is there any effort put into publicly promoting healthcare technology systems to non-physicians nor is there much effort behind celebrating non-physician care givers and administrators as the industry’s leading users of HIT.

It should come as no surprise that non-physician practice employees, such as RNs and PAs, use the systems like electronic health records, much more than their physician counterparts, on average. But, for whatever reason, HIT messaging is all about the physician and continues to be tailored to these mascots and figureheads within practices and healthcare settings.

EHR Watch’s editor, Jeff Rowe, recently published a blog post about the amount of time physicians use healthcare technology as opposed to their in-practice colleagues like RNs and PAs.

In his succinct summation PAs and RNs spend more time online for professional purposes than physicians; during consultations, PAs and RNs leverage mobile applications more at the point of care than physicians; and, in his words, “PAs and RNs use pharma or biotech websites more frequently than physicians and are more interested in using pharma features on electronic health record systems (EHRs).”

If physicians spend most of their time seeing patients and administering care, there’s nothing shocking about this data. It’s a good thing; they need to be seeing patients, not playing around on their computers.

However, this information should validate what everyone in healthcare already knows: Physicians are not the only ones using healthcare technology, and more can be done to include healthcare’s other care providers (and leaders) in the conversation about the technology and how it affects business and patient care outcomes.

The data Rowe provides also should encourage practices to continue including non-physician team members in the selection process of new technology if they are not already doing so because, clearly, though physicians are experts in providing care, they are not always the experts in using a practice’s technology solutions.