An article posted recently to LinkedIn—about the jobs most and least likely to fall victim to robot replacements—started me thinking about the place of technology in healthcare. One takeaway from the article is that automation is best deployed for tasks that are manually or cognitively repetitive, freeing humans to specialize in tasks that are non-repetitive and non-predictable, ones the writer describes as requiring “human intuition, reasoning, empathy and emotion.”
That was exactly the promise of electronic health record (EHR) technology—routine bureaucratic tasks would be automated, freeing doctors and staff to do what they do best: treat patients. Yet in a recent study published in the Annals of Internal Medicine, ambulatory physicians spent an average of a full hour at the computer for every hour they spent face to face with patients. Imagine automating a factory and discovering that workers now worked twice as long, or produced half as much, because of the time required by the new technology that was supposed to reduce their workload.
Paradoxically, with recent advances in technology, it is now more possible than ever for EHRs to fulfill their original promise—and more; the problem is that most of the EHRs being offered to medical practices are simply the wrong technology. In an attempt to meet standardized government regulations, vendors have created standardized EHRs—gigantic, one-size-fits-all behemoths that attempt to meet the needs of all physicians, but end up missing the mark with nearly everyone. Particularly when it comes to specialists. KLAS’ Ambulatory Specialty 2016—One Size Does Not Fit All—Performance Report found that although traditional EHR vendors try to cover all specialties, fields like ophthalmology, orthopedics, and dermatology still lack the functionality required.
This is why one size definitely does not fit all. The right EHR solution for a hospital or general practitioner, seeing a limited number of patents with a wide variety of conditions, will look quite different from the EHR for specialists who see a high volume of patents with similar complaints. And of course, different specialties won’t want exactly the same EHR, either, making flexibility—rather than universal applicability—a major prerequisite.
No wonder that 86% of specialists, according to Black Book Market Research, agree that the single biggest trend in technology replacements these days is the move to specialty-driven EHRs because of the workflow and productivity complications that accompany conventional, template-driven EHRs.
Unfortunately, the problems with inflexible, template-driven EHRs don’t end with the lack of specialty-specific solutions. A secondary, but still significant, concern is the inability of many EHRs to be tailored to the need of individual physicians within the practice. One doctor may prefer taking notes, another inputs her own data, while a third dictates; one may be comfortable communicating through a patent portal, another prefers the phone. True flexibility means that no provider has to change the way that he or she has been practicing medicine simply to satisfy the demands of a generic template.
It also means that, when it comes to increasingly crucial matter of data collection, the decision about how data should be collected—what should be collected electronically and which should remain manual—is left up to the individual practice. In the next blog, I will look at what is called “role-based data entry,” and how this can increase productivity and cut costs.