EHRs designed with clinicians in mind — 3 Qs with Allscripts' patient safety expert

The healthcare industry is experiencing what some have dubbed an "epidemic" of clinician burnout. Many experts have pointed to the broad adoption of EHRs as a prominent contributing factor to this problematic trend.

While the EHR has significant potential to improve care, the initial adoption of this technology left many providers reducing face-to-face time with patients in order to keep up with computerized tasks. To reduce burnout, it's important that the new wave of EHRs be designed with clinician well-being in mind.

Geoff Caplea, MD, medical director of Alscripts' patient safety program, recently responded to three questions for Becker's Hospital Review regarding the importance of clinician well-being and EHRs.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What are some observations you see in terms of clinician well-being right now?

Dr. Geoff Caplea: Clinician well-being is a top priority across the healthcare industry right now and for good reason. Not only is burnout detrimental to individual clinicians, as illustrated by alarming rates of depression and suicide, it also puts the other aims of the Quadruple Aim at risk — decreasing healthcare safety and quality, threatening the health of patients and communities, and increasing the cost of care.  In short, when clinician well-being suffers the entire health system suffers.

As part of Allscripts' commitment to address clinician well-being, we recently became a Network Organization as part of the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience, a group of more than 100 organizations nationwide focused on improving physician well-being. Our commitment statement details the efforts Allscripts now has in place that prioritizes product safety and usability and supports users with better insights, advice and efficiency.

Q: How does Allscripts think about clinician experience when designing technology?

GC: Clinician experience is foundational to the design of our solutions, and we focus on the factors that directly impact product usability and clinician experience throughout our design process. In addition to engaging clinicians throughout the process, we follow six guidelines and will continue to build on them as part of our commitment to clinician well-being.

  1. Educate our associates on clinician well-being, burden and burnout.
  2. Uphold a robust user-centered design (UCD) process.
  3. Maintain UCD tools for development teams.
  4. Measure baseline usability, identify usability goals and continuously improve product usability.
  5. Promote a helper philosophy — moving beyond basic usability to create more helpful solutions
  6. Drive change through a cross-disciplinary approach — including clinical, user experience, development, client delivery, patient safety and other disciplines

Q: What actionable things can healthcare do to make EHRs more meaningful and easier to use for physicians?

GC: Given the abundance of health information for which clinicians are responsible, it is imperative that healthcare identify helpful solutions to ease the burden of creating insights from this information tsunami. As patient-generated data and additional sources of data become ubiquitous (such as genomics, social determinants of health), this problem will only get worse.

Artificial intelligence and machine learning are vital solutions for healthcare because the technology helps clinicians sort through the sea of health information they encounter each day when caring for their patients. Utilizing this technology, clinicians are empowered to more effectively and efficiently deliver high quality patient care. This is even more important as healthcare continues its transformation to value-based care. 

As with any technology, machine learning needs to be thoughtfully delivered in a way that helps clinicians and does not add to their burden. This is the approach Allscripts took in incorporating machine learning into its new EHR, Avenel. Avenel's machine learning engine and mobile design help reduce clinician burden and improve the clinician's experience. Avenel uses machine learning to eliminate the need to scour the health record for useful information and provides insights and thoughtful recommendations to aid clinical decision-making.

Precision medicine is instrumental for improving health outcomes because it personalizes a patient's care based on her genetic makeup, environmental factors, lifestyle and family history.  By incorporating this unique information into the diagnostic process, the patient's care plan can be tailored for more personalized disease treatment or prevention planning to deliver the best clinical outcome.

For example, clinicians at University Hospitals Cleveland put precision medicine directly into the clinical workflow with a solution from our fully owned subsidiary 2bPrecise. With the genomic data already part of the EHR system, clinicians can now more easily access patient information and develop customized treatment plans for patients.



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