Electronic Health Reporter

Guest post by Paul Brient, CEO, PatientKeeper, Inc.

Vice President Joe Biden recently took the stage at Health Datapalooza in Washington, D.C. to discuss where healthcare technology currently stands, and he didn’t hold back. Among other things, he chastised the industry for poor health IT system interoperability and the resulting difficulties it causes providers and patients. “We have to ask ourselves, why are we not progressing more rapidly?” Biden lamented.

Biden’s criticism is only the latest high-profile commentary about the unfulfilled promise of information technology in healthcare. AMA leaders and individual physicians have been grousing about it for years. We’ve seen technology increase efficiency, reduce costs and improve productivity in every other industry – but why not healthcare?

Ironically, seven years after the passage of the HITECH Act of 2009, doctors are less productive than they were before, and IT is the culprit. Rather than enabling a better, more streamlined workflow, IT has become a burden.

The drag that IT is placing on healthcare providers is a principal reason why U.S. Health and Human Services (HHS) Secretary Sylvia Burwell announced with great fanfare at the HIMSS16 conference an “interoperability pledge,” which vendors and providers alike are encouraged to take. Its purpose in part is “to help consumers easily and securely access their electronic health information, direct it to any desired location, learn how their information can be shared and used, and be assured that this information will be effectively and safely used to benefit their health and that of their community.”

This call resonates because the promise of better healthcare through technology has been broken. Technology has changed the way we communicate, the way we shop, the way we watch TV, the way we drive, and the way we interact with our homes. As an industry, healthcare is lagging way behind. The consequences are drastic. In order for us to deliver the kind of holistic care that will truly improve people’s health, it’s time not only to talk about the potential, but to make it a reality for users and providers across the healthcare continuum.

Here’s the reality: we have today what 10 years ago was called a supercomputer in front of physicians – a device that knows virtually everything about the patient – but it isn’t helping out in ways that we take for granted in our everyday lives when we shop online, use Google Maps or order an Uber.

One of the challenges is that the healthcare industry had to get off paper and onto the computer first.   For the most part, we’ve finally done that through widespread adoption of electronic health records. Taking paper paradigms and moving them to the computer was a logical first step, but it can be awkward and doesn’t necessarily yield positive change. For example, we still have clinical notes that are separate from orders. We have told doctors not to write on paper anymore but they are doing largely the same thing they were doing before, just on the computer. If anything, computerization of clinical notes has had unintended negative consequences: notes have become more cluttered—and therefore less helpful—as physicians now routinely include the last 24 hours of results in their notes simply because it’s easy to do so with a mouse click. To date, no one has helped doctors take advantage of the computer to write better notes.

Now that we’re “computerized,” we have to make the computer an essential tool. It needs to adapt to the way physicians work and seamlessly integrate into their workflow.  It should know and suggest things that doctors on their own don’t and can’t already know.

What a physician understands about a patient’s situation – the patient-specific “knowledge base” upon which his/her clinical diagnosis and treatment plan are based – is determined by the information that’s presented on the EHR screen. Which points to another problem: unlike the world of paper records, with its illegible handwriting and overstuffed files, today’s primary obstacles to communication clarity and efficiency are poorly designed data presentation on computer or tablet screens, fragmented information sources and unwieldy interfaces that require dozens of mouse clicks or screen taps by busy clinicians.

I believe we will start to see a change over the next several years as the HITECH Act-inspired “meaningful use” program winds down and we are able to get back to innovation that’s focused on streamlining physician workflow and improving patient health at the local level rather than complying with the letter of government mandates. As we begin to leverage the innovative, ground-breaking tools we have at our disposal, information technology will significantly enhance the healthcare experience, not hinder it.