The automation complication: Three ways healthcare digitization can improve care delivery

The media is replete with stories about how healthcare IT complicates physicians’ lives and compromises patient care.

Last month, there was even a story about how a digital system can promote self-defeating behavior by physicians. The Journal of the American Medical Associationreported that more than 80 percent of the content of physicians’ notes in electronic health records (EHR) systems is copied and pasted by doctors from their previous notes. The result is note bloat and cluttered documentation – less meaningful information is communicated in more words and screens, and the most valuable information gets buried. It is therefore harder than ever for clinicians to distill from EHR notes what they really need to know to deliver patient care.

In the realm of electronic order entry, stories of physician frustration have been associated with CPOE software for decades. Moreover, it is now widely accepted that many physicians spend as much as 50 percent of their work time getting data into or out of an EHR system and other administrative tasks.

How did we get here? Partly by (poor) design. Most EHRs simply automate what is already there; they present information in the same way as paper records did, rather than utilize computers to their full and unique advantage. They completely neglect the specialty of the user, the individual patient situation or the care setting.

As a result, today’s doctors actually are less productive than they were in the past, when they worked exclusively on paper. Rather than enabling a better, more streamlined workflow, EHRs have become an administrative burden to doctors, when what doctors need are digital tools that make their daily tasks easier and more efficient.

So one might wonder: Can IT really provide benefits in a clinical care setting?

In a word, yes. For all the well-publicized problems that EHRs have caused, digitized healthcare is slowly but surely starting to become an advantage. New innovative technologies are actually improving the way care is delivered. Here are three examples of healthcare digitization that are starting to make physicians’ lives easier and care delivery better:

1. Artificial intelligence (AI) – This emerging technology is helping to support clinical decision-making, by putting the power of machine learning at the cutting-edge of care delivery. Here, healthcare is taking its cue from other industries. Take Amazon’s “suggestions” page, for example. Through data analytics and IT, the website automatically makes recommendations on items consumer shopper may want to purchase. A similar concept can be applied to doctors’ patient orders -- AI can recommend which orders should be considered based on an analysis of treatment patterns in similar patients. Such an application saves doctors more time by putting orders simply a click away, and may even help avoid a missed or delayed order that could ultimately save a patient’s life.

2. Adaptable user interfaces – Adaptable user interfaces have the capacity to transform the way that doctors work by changing the way clinical data is presented based on a range of factors: the doctor’s specialty, the care setting, and the current patient situation (e.g. pre-op, post-op, etc). With paper-based health records, there was only one view, and no way for a specialist to easily access the most important information pertinent to him/her at a point in time. With adaptable electronic interfaces to a computerized patient record, doctors are able to save time and reduce the chance of missing a critical piece of information.

3. Big data analytics – Clinical insights driven by “big data” analytics are helping to contribute to more efficient and actionable healthcare. One of the most promising applications of big data analytics is the early recognition of sepsis in the hospital environment. Life-threatening sepsis, according to The National Institute for General Medical Sciences, strikes more than a million Americans every year, with an estimated 28 to 50 percent of those infected succumbing to the disease. That accounts for more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined. One of the biggest reasons for this high mortality rate is the rapid progression of the illness, which requires quick detection and intervention. With a digitized health record and the constant vigilance of an inference engine, patients at risk for sepsis can be identified more quickly, when the disease is in its earliest stages, vastly increasing the number of lives that can be saved.

It is widely acknowledged that healthcare automation holds immense promise. EHRs, even once their usability problems are solved, are just table stakes. With the right technology foundation in place, the industry can build upon it to improve care quality and efficiency across the entire healthcare continuum. Then, and only then, will we start to see the full value of healthcare’s digital transformation.

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By Paul Brient, CEO, PatientKeeper, Inc.

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