Provider Perspective: Filling in the Pieces Between Patients, Policy and Products
The technology is out there, and the patients are ready for it, but what about the providers? As we mentioned before, even the early stages of embracing early EHR implementation has led to provider frustration and hesitation. But there are professionals out there that think that the gap between patient need and product limitations can be filled adequately by the provider taking both into consideration upon clinical application. One such professional is Stephen Beck, CMIO of Catholic Health Partners.
Beck’s organization, which is the largest health system in OH, has been recognized for successfully integrating a standardized EHR system developed by Epic throughout all of its hospitals and employed physician practices. The initiative was known as Care PATH (patient-centered access to team-based healthcare).
So what’s behind CHP’s accomplishments? Aside from adopting the simplistic mantra of “one patient, one record,” how or why has it succeeded where other providers have failed? Beck answers:
“Our project is a clinical project, not an IT project, and it has been led by a coordinated team of clinicians across our enterprise since our rollout began,” he said. “Our providers helped design critical areas of our build and are constantly giving constructive feedback toward enhancing our system. Provider input, not simply physicians, but mid-level providers, nurses, pharmacists, therapists, and others is essential to the success of any EHR implementation, and it is essential to its continued success.”
Beck said the technology to make connections with patients has been available for years but he sympathizes with the challenges that providers have faced upon embracing it, citing fear of data loss or patient privacy as valid concerns. Yet, he acknowledged there are tools to help strengthen the provider/patient relationship. “The patient must be at the center of this transition. Our largest struggle is not with the patient who takes their medication regularly, but with the patient who does not engage in their own care. Technology can be the driver that excites a patient with the prospect of wellness.”
When it comes to the future, Beck and Chase are on the same page: “Rome wasn’t built in a day,” said Chase. “Even the most advanced organizations around patient engagement rolled out the new capabilities in stages. There is an explosion of new products. Those that succeed will be patient-centric from the ground up, and will allow for staged implementations. That process will differ from the massively long implementations that result in rigid systems. Instead, I expect they will be more agile and iterative. I am 100% certain that technology will help fill the gaps. It just won’t come from the traditional health IT suppliers alone.”
What the Hand-held Future Holds
With that in mind, patients will play an even larger part. “You can’t develop these systems in a vacuum—the patient must be part of the development process. We interact a great deal with consumers. With over 174 million monthly unique visitors, we can observe what they are looking for, survey them and more,” said Chase.
Such will be the same for providers, like Beck, as more and more ways to harness the wave that is big data continue to surge from the developments for mobile devices, healthcare apps and wearables. This impending accumulation and convergence of patient and provider data is what makes ePatients, like Holliday, hopeful for the future; she would like to see a patient on every executive panel, every workflow, every committee and involved in every aspect of research.
Until that happens, her work isn’t over. There are still pieces missing to the puzzle that is HIT, but slowly they are coming together as the human element comes back into focus and the ePatient becomes a valuable part of the conversation.
“I often talk about a children’s toy called the 20Qball,” said Holliday. “It plays 20 questions with you. It is loaded with a dictionary, a mathematical algorithm and auto-taxonomy. The ball asks deductive questions to figure out what you are thinking and the ball almost always wins. I want to see this kind of technology in healthcare. I want to answer questions posed by a computer that functions like Watson. I want those answers to be considered by interfaces like Archimedes. Then…I want a warm, live and breathing doctor to hold my hand as we discuss the outcome together.”
As we conclude this chapter, I ask the same question that we started with: Why has it taken so long for the ePatient to take its place in the HIT evolution? Because an evolution is just that—a slow and iterative process that yields both failures and victories. Is the ePatient’s emergence healthcare’s victory? That remains to be seen. But what seems quite clear is that if we are going to get this patient engagement thing right, we have to balance the touch points that make us human with the touch screens that connect us. Technology will continue to change. Natural compassion will continue to cost nothing. But only one never becomes obsolete.
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