We’re in this together: The healthcare provider and patient revolution
I recently spoke at the HIMSS UK e-Health Week in London about ensuring adoption of information technology by users. Specifically, what it would take for providers to begin using technology to treat patients.
It was an invigorating talk, made all the more urgent because of the NHS Paperless by 2020 and similar initiatives throughout the EU. However, after spending the last 24 years in healthcare in the US, witnessing firsthand the rise of electronic patient records, I can’t help but think we are missing something.
I’ve recently moved to the UK and have been impressed with the people of the NHS. I know, there has been a lot of talk about delayed transfers of care, missed appointments, and the junior doctor’s dispute. However, I’ve experienced top-notch healthcare whilst living in the UK and have met the caring and committed professionals of the NHS.
What’s the biggest buzz I’m hearing?
In the UK, it is NHS Paperless by 2020. It is an ambitious initiative. I’ve traveled to other European countries and studied their healthcare systems. Many have the same modernisation mandates as the UK, with the goal of improving patient outcomes: Interoperability/Record Sharing and Electronic Patient Record (EPR) Adoption.
I’ve been reading a lot of articles lately from various publications on both sides of the pond about electronic medical records (EMRs) and EPRs and what they should do, shouldn’t do and how they will benefit patients.
But will they? And just how will they benefit the actual staff charting in them?
There has been a lot of discussion of late of transformation in healthcare. Much of it centered around applications. The current generation of teenagers will be the first to never have a landline telephone, to know what a dial-up modem sounds like, or to have a genuine relationship with their general practitioners (GP).
Engaging – and healing – patients with technology
In this day and age of 10-minute appointments, and the GP shortage in the UK, how can they hope to have meaningful discussions? But, given the fact that some of this generation will become tomorrow’s clinicians and have grown up with incredible technology, we have an opportunity to engage them with this technology.
How will an EPR help this generation to take accountability for its health or providing healthcare? Is it really through charting electronically? Or is the solution something more human-focused? How will an EPR encourage people to go to Urgent Care or their GP for non-emergent conditions instead of the A&E?
Will the EPR remind you to take your meds? Record your weight? Encourage healthy lifestyle choices?
Don’t get me wrong. An EPR is essential in caring for patients. It can provide clarity for clinical pathways, show trends of a patient’s vital statistics, and document procedures. It can also assist in ensuring dangerous drug combinations or dosages are not administered, and assist in diagnosing illnesses. It is built for providers to document information during an encounter with the patient – or the patient’s x-ray, blood, etc.
What it can’t do is change human behavior. That’s right, the cold, dark secret of modern medicine: There is no ‘’killer app.’’
I’ve been in an integrated delivery network that implemented an EPR, and I’ve been a patient in that same network. I’ve witnessed the highs (I can schedule appointments online!) and lows (my GP looks at the screen and types instead of talking to me). My current GP sits at her desk and does the same thing.
And it will take time to implement EPRs and get any productivity gains out of them, if any. We say one of the benefits of implementing an EPR is that it will cut down the time required for charting. But, on the other hand, we also say we will be able to capture more discreet patient data.
Record more data in less time? Really? Unless we are also implementing Star Trek-like tricorders, I have a hard time believing that. EPRs are one part of the transformation. But getting the right information into the provider’s hands means using multiple sources of information.
Beyond tech: A human healthcare revolution
We need a revolution. We need to engage the patients BEFORE they need us and we need to be realistic about what EPRs can and can’t do for providers as well as patients.
What do patients and providers need? Education, information, ease of use, and a sense of shared responsibility.
For all the talk of digital transformation, there also needs to be a human one as well.
Want patients to use their GP instead of accidents and emergency (A&E)? Increase the number of GPs, educate patients on their alternatives, and reward them for their selection. Make it easier to schedule appointments on smart phones, message your GP or chart your own health.
Want providers to chart in the EPR? Make it easier for them, more intuitive, and limit the discrete, structured data they have to capture. Supplement information through unstructured documents (X-Rays, written notes, etc.).
Let’s start the revolution together. The world is waiting on us.
Meanwhile, I’ll be attending eHealthWeek in Amsterdam, 8 – 10 June. If you’re ready to join me in the healthcare revolution, come to booth N9.