Patient care—that’s all I hear.
Since 2007, whether at a healthcare conference, reading an article on healthcare technology, or in the vendor brochures I perused on doctors’ desks, everyone was talking about patient care. Patient care this, patient care that, improving patient care; patient care was, and still is, the mantra of the healthcare IT masses.
As good as that sounds, it’s the wrong focus.
Coming in from the outside of healthcare—which seems like entering another world—I saw that it is the physician we need to worry about. With so much changing in the healthcare world, the future options for doctors are narrowed down to a handful of choices:
- Merge with a large provider.
- Sell out to a hospital system.
- Go into research.
- Venture into concierge care.
Staying where they are is no longer a viable long term option for most. It appears that very few of these options have the likelihood of improving patient care, most may only maintain current patient care, and one or two options may actually be detrimental to patient care. The way I see it, those are not good odds. And the odds didn’t seem to improve with new healthcare IT developments over the past 10 years. I believe a significant cause of this result is due to the definition of an effective system for patient care being defined by government (e.g., meaningful use checklists) and not physicians on the front line. But I digress.
We have mushrooms growing in the office.
The current processes and systems are buried, still growing and eating up available funds, but not being used effectively by the physicians that they were originally intended to help. Two of the most familiar are the EMR and HIE mushrooms. Both are good at eating and storing data, and some can even regurgitate, but they either spew too much or have acid reflux when they do—and that is the key. For the EMR and HIE to be truly effective for doctors, data needs to be shared. This is self-apparent. We’ve got systems on each end and a wire in-between, so it should work, and everyone know this.
So then the question becomes: How do we do this effectively, no matter what the system, or lack thereof? Unfortunately, the common answer is still the fax or, more recently, the patient/doctor/hospital/lab/specialist/HIE portal. Why? It’s not because we need the data electronically—we’ve got that—but we need the right data. And there’s the rub.
What makes the portal and fax work over interoperability is the simple, yet time consuming, process in which the doctor can find what is needed and put it into a system for storage, whether that’s an EMR or a folder in a filing cabinet. Doctors maintain control.
Current interoperability doesn’t offer that. Hospitals send discrete data of everything being done for a patient, whether the doctor wants it or not. The doctors’ EMR accepts everything, whether or not the doctor wants it. Doctors lose control, and the process creates more work to get control back.
When we moved our interoperability framework for the media advertising industry to in 2014, we thought, naively, that it was a simple matter of connecting EMR to EMR to HIE to EHR, etc., and turning on the tap. But it wasn’t. The doctors needed something that filters and renders only the patient data they currently need, without being overwhelmed. And that took a while.
We had to consider the needs of the physicians, the capabilities of their EMR, the capabilities of the community (hospitals, specialists, labs, etc.) before tailoring the process for each of these relationships in the healthcare community. The result of our research and labors was the creation of a realistic discriminator.
With the discriminator, providers can now access the right data about their patients, in the form they can use or their EMR can handle, while eliminating the time it previously took to manually retrieve and store the information. Saving this time saves money.
With the time and money savings, we were able to offer a sixth option for physicians: staying in their practice because they can afford to, and thereby improving doctor care.
Improving doctor care improves patient care.
Published Jul 22, 2016