I just opened a daily blast from Beckers and happened across an article in which John Halamka, MD of Mayo Clinic reports “going from paper charts to fully digital ended up losing the hearts and minds of clinicians and nurses.”
He goes on to describe that physicians were handed an automated record that requires them to type data into 140 data fields for every patient visit (which apparently average about 11 minutes). How does the physician actually see the patient with any empathy at all and still manually enter data into 140 fields?
I have tended to experience this from “the other side” of the discussion (as a patient) in which it felt like my physician was so busy working on the computer that he didn’t have time to look at me. I asked my physician about it and learned that the decisions regarding what he had to record in my record were dictated by the health system that owns his practice. He told me I was lucky that I wasn’t yet on Medicare because the list gets longer.
Some of this undoubtedly occurs because there are still disconnected systems. Why is it that I fill out a whole bunch of information on my physician’s office portal only to have to write it on a piece of paper when I get there and then get asked about the same information when I get into the examination room?
I found myself wondering what those 140 data elements were, how often they change, how often they get used for something, and how often someone looks to see if the “juice” of the captured data is worth the “squeeze” of getting it.
I found myself wondering who is imposing these data collection schemes on end users, and by what processes they get reviewed and approved Who is it who thinks that tying up a physician or nurse to collect all this data (especially if typing it in by hand) is the right thing to do? Is there a physician or nurse at the table when these schemes get hatched?
The article goes on to assert that “administrative burdens such as EHR documentation cost U.S. Healthcare $1 trillion annually.” There needs to be a lot of juice for that squeeze!
How do we get our systems to be more efficient in capturing and exposing data without excessive data entry? How do we get our systems to actually help us work more effectively? It certainly seems like we have not been heading in the right direction with our systems.
This isn’t limited to clinical systems. It often feels like our operational systems tend to default to making us enter, and re-enter data that could be shared or otherwise found on our behalf.
As always, this blog represents my own thoughts and not necessarily those of ASHP or of my employers.
What do you think?
Dennis A. Tribble, PharmD, FASHP
Ormond Beach, FL