Empowering the clinician around the EHR

John Steinbeck once said, "Anything that just costs money is cheap." That time-tested adage has never been more true—especially when it's applied to the modern US healthcare industry.

Imagine being forced to spend millions of dollars on technology that promises to increase efficiency and profitability only to find yourself spending two to three additional hours each day on data entry, while also enduring 30 percent reductions in both pay and initial productivity. That's how many hospitals, health systems and clinicians feel about the current state of Electronic Health Record (EHR) systems.

The Health Information Technology for Economic and Clinical Health Act (HITECH), which was part of the 2009 $787 Billion economic stimulus, incentivized the "meaningful use" of EHRs to "achieve significant improvements in care." As a result, EHR vendors are caught between clinician desires for ease-of-use and government mandates. It's no wonder that the most recent Physicians Foundation study of more than 20,000 clinicians found that, while 85 percent had adopted EHRs, more than four-fifths described themselves as either "over-extended or at full capacity." Nearly half (46 percent) reported that EHRs had detracted from their efficiency. Another recent survey found the same percentage of physicians described themselves as suffering from "burnout."

Clinician blues
While EHRs certainly fill a necessary role in this digital age, clinician complaints about them range from poor design and lack of interoperability to interruptions in workflows and the resulting reductions in productivity. These usability frustrations unfortunately limit the technology's ability to help improve care, because they add hours' worth of redundant tasks each day and require dozens of clicks to review a single note, which infringes on valuable patient interactions. Instead of driving more collaboration between providers, patients and payers, EHRs are building unintended silos.

Unhealthy mandate
To be fair, most EHRs aren't designed just to improve clinical care. Instead, they're engineered to comply with federal regulations such as those mandated by the 1996 Health Insurance Portability and Accountability Act (HIPAA). Among other things, HIPAA has strict security requirements to protect patient privacy. Of course, safeguarding people's identifiable health information is crucial, which is why the costs of non-compliance are steep—ranging from $25,000 annually to $1.5 million or even prison sentences for the worst offenders. Is it a wonder that EHR vendors are, in the words of one physician, "focusing on qualifying their systems for the next meaningful use?"

The Catch-22
Today, clinicians often work across several different hospital systems, which can require them to interact with a number of different EHRs, each with its own set of security features including intentionally complex passwords and two factor authentication. Doctors and nurses must log in and out of multiple EHRs dozens of times each day as they move between clinics, patient and exam rooms. As one might imagine, all of those extra steps are causing a lot of stress for healthcare workers who would prefer to do the one thing they do best—serve their patients. And, therein lies the catch 22. Improving patient care is one of the primary directives of the 2010 Affordable Care Act (ACA).

Patient suffering
The move away from a fee-for-service model toward value-based care is a noble goal that one would think would be a big win for patients. Unfortunately, many patients are feeling the pain as clinicians spend ever-more time dealing with the dizzying array of technological and regulatory burdens. A recent Prophet study found "an alarming 81 percent of consumers are unsatisfied with their healthcare experience."

While a few health systems are already "using advanced analytics to translate large amounts of data about a patient's condition and behavior to actually anticipate the need for interventions and revise care plans," ultimately, it won't be providers or EHR vendors who will determine the future of healthcare technology—it will be the patients themselves. Increasingly, consumers are taking their health into their own hands. Consider the following:

• In 2014, more than half of consumers believed mobile devices helped clinicians better coordinate care
• Nearly half of consumers were willing to communicate with providers online
• Last year, 58 percent of consumers had a "healthcare, wellness or medical app" on their smartphone (up from 28 percent the previous year and 16 percent in 2013)
Those numbers reflect the growing trend toward more consumerization in healthcare, and are creating opportunities for health organizations that put the patient first.

The cure
With the entire system in unprecedented upheaval, some forward-thinking providers are finding efficiencies in the areas they can affect most quickly. They are supplementing their EHRs with alternative, secure collaboration solutions to streamline communication and knowledge-sharing within their practices, as well as externally with patients, administrators and payers.

It may seem counter-intuitive to suggest that more technology is the antidote for the challenges of EHRs. However, new, secure collaboration platforms excel at easily capturing human conversations, questions, answers and ideas -- filling the gaps of today's healthcare technology, and aligning perfectly with the ACA's triple aim goals of enhancing the experience of care, improving the health of populations and, ultimately, lowering the cost of healthcare. Other industries have successfully used these types of solutions to improve workflows and engage employees in the ways they work best for years.

By reclaiming efficiencies from the slowdowns that are inherent to complicated EHR implementations, new technologies are creating better outcomes for clinicians and patients alike. But you shouldn't just take it from me—John Steinbeck also said, "No one wants advice, only collaboration." And in today's healthcare environment, those are words to live by.


Author Bio
Bill Klco has twenty-five years of experience in the technology and healthcare industries, holding leadership positions at Baan Company, Cerner Corporation and Spectrum Health. Bill currently serves as Director of Healthcare at Jive Software where he is responsible for developing the company's healthcare practice, including working with new and existing clients to improve efficiencies through healthcare collaboration. Over his career, he has managed technology implementation projects at several large industrial and healthcare organizations, both in the U.S. and internationally. He has a bachelor's degree from Ferris State University and a master's from Western Michigan University.

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