EHRs grew out of the vast computers that looked after a hospital’s internal processes. The physician workflows, on the other hand, were an afterthought.
Imagine a Wendy’s restaurant. You place an order and the guy at the counter rings up and relays your order to the kitchen. When the order comes, the fry guy drops a basket of fries in the fryer, the guy at the burger counter flips a patty, the girl over at the soda machine fills up your choice of soda, arranges your order on a tray, and rests it on the counter before you.
No one needs to coordinate. No one forgets what has to be done and at what moment. But it’s one lapse, and the dominos topple over.
Healthcare is pretty similar – from a patient visit to their examination to handing over a prescription, it could be divided into different segments of processes. But there could be tens of lapses as well. A doctor can’t access the record of a patient sitting before him. Insurance is not verified. A service at the hospital doesn’t get billed. Patients that need to visit for a check-up or screening are not reminded. Workflows end up making or breaking a hospital’s efficiency and outcome- not to mention define the burden that rests on a physician’s shoulders.
The existing challenges with EHRs and physicians’ workflows
Electronic health records grew out of the vast computers that looked after a hospital’s internal processes- billings, pharmacy, lab, scheduling, admissions, claims verification, and of course, visit history. The physician workflows, on the other hand, were an afterthought. There were little avenues that could enable a physician to unify the data they had and the data they needed.
As a result, physicians ended up hopping from their EHRs to their analytics reports, having a hard time leveraging the information they need to improve patient health and incorporating them into their care plans. The EHRs were just developed as systems of records, which held information that replaced the old paper-based charts. Also, notoriously known for their limited interoperability, EHRs became a major roadblock in information exchange across health systems. Despite immense data stored in EHRs, they do little to enhance patient care with the use of data.
Time is money for physicians- and it’s slipping
Time really is a precious thing for physicians. A physician spends a little over 18 minutes, documenting patient visits on their EHRs, compared to 16.5 minutes of face-to-face interaction time with their patients. The explosion of data systems in healthcare has rendered physicians scouring for useful patient information from all corners. The lack of information that is valuable for physicians is difficult to curate and access.
The problem isn’t that the physicians are busy. It’s that they are not spending time doing what they want. Instead of interacting with the patient, they are just clicking away the vast amount of data that gets dumped on them. Not only the process of delivering care gets stretched out, it also leads to physician burnout.
Striking a balance is important here- physicians will have to attest to reporting requirements, they will have to navigate various platforms to find anything that could potentially improve patient care, and they will have to mitigate the bunch of alerts and notifications signaling their patients’ well-being. But it has to be better and it has to be efficient.
The benefits a physician-friendly workflow could do
Physicians are at the epicenter of every transformation in healthcare. Every healthcare process begins with them and it’s extremely important that they are seamless. Today, in most physician offices, workflows are a combination of interrupted processes. Additionally, since the expansion of the care continuum, the lack of coordination among different practices has become rampant. Physicians end up waiting for someone else to do their jobs so that they can do theirs- and the number of delays, redundancies, and ‘dropped balls’ has become too overwhelming.
An integrated, physician-friendly workflow should enhance the efficiency and streamline processes- not hinder them. It’s all about providing the right data to the right person at the right time in the right volume. If the relevant information was available to the physician right at the point of care, notifying them about the codes that were dropped or the screenings that were missed by the patient before them, that could save a good deal of time and improve physician efficiency.
In addition to that, when physicians would have complete information right at the point of care, they’d know what’s missing in a patient record and how to bridge the gaps. This is becoming an increasingly important part as patients receive across multiple settings and to improve overall outcomes, these different settings must be on the same page. A well-defined workflow could be vital in relaying patient health information across the continuum and coordinate overall care.
Efficiency is key to improved outcomes
When you improve a bad process with good technology, it remains a bad process. The goal of integrated workflows is to provide efficient and effective patient care, which in turn, will improve an organization’s outcomes. But it’s too much information along and broken coordination between pieces that do the exact opposite. The technology is meant to support physicians as they provide care, and not the other way round. Using valuable data at the point of care has the potential to bridge gaps in care in a much faster, efficient way and that’s the most significant thing physicians should be able to access.
Abhinav Shashank is the CEO & Co-founder at Innovaccer Inc., a datashop integrating complex data across multiple distributed sources to give healthcare organizations greater insights to provider better care.