As the New Year arrives and health care continues its rapid evolution, one of the most critical challenges that we face is the interaction of information technology with frontline clinical medicine. If you were to ask, at the start of 2016, any physician (or even nurse) what their biggest daily frustrations are — most would list health care IT at or near top of the list. And it’s not just the clinicians either. The same goes for patients, who are increasingly frustrated with their squeezed time slots with physicians, with much of the time annoyingly spent with the doctor looking at the computer screen instead of them.
In no other facet of life, aside from health care, has information technology slowed down the professionals at the frontline, reduced productivity, and acted as a barrier to both professional and consumer satisfaction. (I’m going to use the word consumer instead of patient so that it’s comparable to other industries.)
The problem is not the IT itself, which very much represents the future. The problem is that the current crop of solutions are cumbersome and unwieldy. There’s so much room for improvement. Here’s a 2016 wish list to help make the situation better:
1. Acknowledgment that health care is about people and human relationships. Everyone from the world of information technology needs to first and foremost understand the reality of frontline health care and the fact that computers and technology are only an accessory to providing care. All IT solutions should be designed to be seen and not heard — and enable doctors and nurses to get back to where they belong: at the bedside. Studies are now showing that physicians are spending as little as 10 percent of their day in direct patient care, an alarming statistic. It’s time to tip the scales back towards our patients and away from the computer screen.
2.Seamless, efficient and user-friendly technology. The vast majority of major IT systems, when given honest feedback, are viewed by physicians as slow, cumbersome and clunky. In a world where we have access to so many other well designed IT programs via our iPhones and ultra-slim laptops — why does health care lag so far behind? Let’s start with simple screen interfaces and menu options, and work to bring them into the 21st century.
3.Mobile solutions. Most hospitals and clinics are still hooked on the old desktop, keyboard and mouse model of working on computers. Certain important health care-related tasks, such as gathering quick information and placing orders, should be enabled via mobile technologies. This does not necessarily mean that physicians and nurses should spend their time with patients staring at iPads, but does mean that we should take advantage of all available technological advancements to make our work more efficient.
4.Communication between systems. The fragmentation of U.S. health care means that there are way too many IT systems out there that don’t communicate with each other in any meaningful way. For example, many hospitals within the same health care system are not wired to be able to access each other’s records, and even within the same hospital there may be several different programs that need to be accessed on the computer in order to get complete records for one patient. For instance, there may be one program for looking at scans, and another for cardiology results. Surprisingly too, it’s not uncommon for Emergency Departments to have completely different systems from the rest of the hospital! This incongruity needs to be resolved.
5.Working together. Most important of all is that the world of health care IT and clinical medicine need to come together in order to improve on the design and implementation of all current and future systems. Without formal frontline input, there is no way that IT professionals know how to do this (and quite frankly, their solutions are quite scary without physician and nurse feedback!). This should occur at both a local and national level.
Hopefully, 2016 will be the year when we make more progress in this all-important area. Unfortunately, since the proliferation of health care IT began over the last decade, most New Year’s wish lists about this topic would have looked similar to the above. Maybe, just maybe, this will be the year.
Suneel Dhand is an internal medicine physician and author of three books, includingThomas Jefferson: Lessons from a Secret Buddha. He is the founder and director, HealthITImprove, and blogs at his self-titled site, Suneel Dhand.
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