The interoperability paradox: Is technology the key to putting the “human” back in healthcare?

In today’s world of technology, there are many who worry that the personal care of patients is being compromised as care teams must often sacrifice time with their patients for screen-time. And as an RN of 43 years, I have seen many patients fall through the cracks of the healthcare system.

But I have also seen how technology platforms—especially those that facilitate care collaboration and interoperability—can help catch those patients and provide a higher level of care.

Living in the Age of Technology

It’s true—a patient lying in our ED won’t always have a nurse in the room, but there will always be the companionship of EKG blips, overhead announcements calling for various medical personnel, and the distant ringing of a telephone.

With increased interoperability between healthcare providers, technology stands to impact not only our hospitals but our medical communities. As ADT-data is pushed seamlessly to primary care provider screens—and skilled nursing facilities automatically receive insights into admissions and readmissions—our dependence on technology will not be the only thing that grows.

Interoperability serves to grow our interdependence, as care team members across the care continuum collaborate toward a common goal: better patient health. Which begs the question—rather than dehumanizing medicine, could it be that interoperability actually rehumanizes medical care?

The True Cost of Wasted Time

Working in an emergency department, I know that time is more than just money. Minutes can be the difference between life and death during an opioid overdose or between a return to normalcy or permanent paralysis or brain damage following a stroke.

And yet research suggests that—due to increasing competing, conflicting regulations and metrics-driven incentives—the average physician now spends just under 50 percent of their day filtering through EHRs and completing paperwork—and 37 percent of their time in an exam room doing similar work, rather than talking face-to-face with the patient. Many physicians reported spending an additional two hours each day outside the office catching up on clerical and administrative work.

While some administrative work is necessary, when it accounts for 25 percent of hospital waste, something has to change. Especially when that administrative work keeps care teams from the patients that need them most.

Health information technologies working together can help reduce that waste by taking the busywork out of the provider’s hands and freeing up time for care teams to actually care for their patients. Studies show that when technology is implemented, hospitals see a 22 percent yearly savings for outpatient, and a 58 percent savings for inpatient care. Implemented nationwide, this would yield annual savings upward of $81 million.

But the benefits of technology extend far beyond cost savings. Using technology to help streamline workflows improves patient care by giving providers more time with patients, and patient families. It frees up hours after work for recharging instead of logging data, for less burnout and more job satisfaction. And as providers thrive, our patients do, too.

Letting People Do What People Do Best

At Legacy Salmon Creek Medical Center, I worked with Collective Medical—an ADT-based care collaboration platform that enabled me to track, download, and sort patient data based on factors like diagnoses, insurance coverage, and associated clinicians. This ultimately helped me identify patient patterns and develop algorithms we could use to risk-stratify patients.

While some might argue that automation and algorithms depersonalize care, what it really does is let technology take care of what it can, and free up people for what people do best: critical thinking.

Based on these algorithms, we could then focus our attention on system issues inherent in our complex healthcare system. Using the same platform, we could send detailed referrals to insurance companies and community case managers—identifying individual risk factors contributing to high ED utilization and readmissions. Technology allowed us to engage with our community partners, so we could work together to identify effective solutions.

Jump in, and the Results will Follow

As interoperability grows, and healthcare continues to discover better ways of making technology work for the provider, healthcare will rehumanize. As care teams spend less time searching for charts and pulling analytics, and more time jumping into the data and synthesizing what those charts and analytics mean, job satisfaction will improve—and patient care will, too.

For us, relying on algorithms to provide better data led to better decisions and better patient outcomes. Within 24 months, we saw a 24.9 percent reduction in all-cause 30-day readmissions for our patients and an 81 percent reduction in the overall ED visit rates—not to mention significant cost savings.

Perhaps unintuitively, technology enables us to spend more time with our patients, collaborating with our own care teams, across medical neighborhoods—bringing together patients, nurses, RN case managers, PCPs, hospitalists, and more.

Rather than fearing the technological advances we have today, we need to embrace them. There’s no time to wait for someone else to discover better workflows; the opportunity is ours to act now on what we have and develop solutions from what we experience. And it starts with embracing the collaboration that interoperability fuels.

Cynthia Miceli grew up in Italy where she became a nurse for many different healthcare settings—including research, ICU, CCU, recovery, occupational health, and coordinating pre-and-post-deployment care for the military. Most recently, she has worked as a certified case manager for Legacy Salmon Creek Medical Center. She loves overcoming challenges in the healthcare system and has enjoyed watching the evolution of healthcare during her 43 year tenure with the advent of technology.


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