WHERE IS THE ELEPHANT: Why Electronic Documentation by Itself Won’t Heal Healthcare
General Grant, Vice President of Strategic Initiatives
In his June 20 Health Data Management article Time for CMS to Get Prescriptive: Electronic Notes and Meaningful Use, author Sean Benson referenced two stats that grabbed my attention:
- Almost 3 out of 4 providers surveyed said they would need moderate to major process and product changes to fulfill a new electronic documentation criterion for meaningful use
- Nearly 80% responded that they still rely on paper records, despite either having or currently implementing an EHR
This aligns with a frustration hospital administrators across the country have shared with me—millions of dollars invested in EMR platforms have resulted in clinicians continuing to use…paper. Yes. I said paper; the very thing it was meant to decrease.
Yet, when you understand the workflow of clinicians, it’s no surprise that doctors and nurses are largely not documenting at the point of care. It’s just too hard. I know, that sounds like a “cop-out.” But in reality, it’s true. To meet regulatory compliance and security measures, it takes a typical clinician 3 minutes to logon and access the correct patient information. And a clinician does this 40 to 50 times a day. What clinician do you know who can afford that kind of time? So, they create workarounds that allow them to capture the information they need on paper, and transfer it later, to the EMR.
Healthcare IT organizations have thrown even more technology at the clinical computing environments—single sign on, virtualization, token-based authentication, personalization management, and the list goes on—to solve the problem. Each technology solves a unique problem, but creates another. The clinicians become more frustrated, do less documentation in real-time, and continue to make errors in documenting care and prescribing medications.
The key to healthcare improvement can be found in technology. Technology that starts with the clinician’s need and supports that workflow, not the other way around. We need to reduce the number of technology products that are thrown at clinical users; the only products clinicians should use are those that support their job, such as the EMR. Hospitals can make real-time documentation a reality by leveraging user, location and patient context to mold the desktop with the applications, services and patient information needed at each point of care—instantly. Sean Benson is right when we says we need clinicians to enter data at the point of care…let’s just do it without requiring more technology.
