EHR has had a long history in American medicine, dating back to the 1960s when the technology was first developed. Throughout the years, mandatory implementation has made EHR commonplace in the medical community, as synonymous with the medical profession as a stethoscope or a tendon hammer. However, asking a doctor for their opinion on their EHR system ushers in a chorus of groans and complaints born out of deep-rooted frustration. Even in 2018, most EHR companies have not improved their product beyond a simple, manual,and technologically dumb storage application for patient data.
Back on May 16th, Abraham Verghese wrote a scathing review of the current EHR climate for the NY Times, documenting technologies contribution to the growing disillusionment amongst physicians. In his piece, Verghese belabors spending “hours on our primitive Electronic Health Records”, making “4,000 keyboard clicks”, and the failed promise of “interoperability”.
Clearly, the biggest problem with EHR is the failure to deliver on promises made by vendors. An EHR system should make everything from patient check-in to diagnoses easier for a physician; but more often than not, workload is often increased. Doctors don’t simply need or want an electronic format of their charts, they want an intelligent, user friendly, and automated system that eases their workload and promotes better care.
Specifically, an EHR system that actually makes a physician’s life easier involves a system with interactivity and intelligence. A successful EHR will be interactive at all levels at an office, from the front office, to the clinical staff, to the provider themselves. At the front office level, an EHR should automatically check a patient’s eligibility, comparing the current chart to the current insurance information and flagging any discrepancies. This interactivity gives the front office room to breath, and allows them to focus on developing relationships with patients while attending to their needs in the high stress arena of the waiting room.
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Additionally, interactivity must extend to the clinical staff and the physician. For clinical staff members, an EHR should immediately flag any gaps in care, and prompt the staff to inform the patient and remedy the problem. For instance, this can include a change in medication or a screening that needs to be completed. Most importantly, an EHR system needs the capabilities and interactivity to flag new, key lab results and complications to the doctor as soon as the patient enters the examination room. An EHR should compare current chart data to the patient’s medical history, and offer suggestions and analysis based on the current complaint as well as solutions that were successful in the past.
Furthermore, an ideal EHR system will also have built-in intelligence, allowing a physician the data analysis necessary to improve care and manage their patient population. For instance, an EHR should provide data cubes separating the patient population by key demographics selected by the physician. This feature would allow the doctor to understand which care options worked for which sections of his population, as well as suggestions on where they can improve care. All in all, an EHR should actually make use of all the data it’s collecting, and give the physician treatment options at a macro level, which in turn will improve care at the micro.
EHR is certainly at a crossroads. Doctors need more than the simple input-output system that most companies are offering today. They need accessibility, interactivity, and intelligence from their EHR. If EHR does not adapt and evolve, more and more doctors will become discontent with their profession, which could potentially hurt our healthcare system and hurt care for our most vulnerable citizens.
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Also, watch this video on our EHR services!
Mr. Verghese @ NY Times