Quit Wasting My Healthcare

Strategy #14 for Improving Healthcare Value: With Healthcare IT–Less is More

There is a big push to improve healthcare quality and cost-effectiveness through the use of electronic medical records, computerized physician order entry and personal health records.  As one speaker I heard say, “Healthcare IT is like mom and apple pie.  Everybody loves it.”  The problem is that every electronic medical record, physician order entry system and personal health record I’ve seen is so complex and over-designed that it is just too cumbersome to use effectively.  It has too many office notes.  It has too many lab results.  It has too many radiology reports.  It has too many options for how to order a test or medication.  No provider has the time or energy to sort through all of it. 

Providers have a millions pieces of information coming at them from a million different places, every second every day.  Patients.  Nurses.  Medical assistants.  The chart.  Phone calls.  Faxes.  Mail.  Forms—oh, the forms.  I have yet to see an IT system decrease or organize that informational clutter—it just adds to it (or rather IT just adds to it).

The one piece of IT that has been useful in my clinical practice and in the practice of my peers is email.  It makes sense for other people in their jobs and it makes sense for providers.  Email is effective because I can articulate in about 30 seconds what is going on with a patient and what I need another provider to follow up on.  On the receiving end, another provider can let me know in just a couple of sentences what they are thinking and what their plan is for the patient.  Everyone knows what email is and everyone knows how to use it.  Medication changes, test results, clinical opinions communicated—all very fast. 

The phone doesn’t work because it is just hard to get two doctors on the phone at the same time.  Everyone is always in seeing patients or in the OR and physicians HATE waiting on the phone.  With email there is no waiting.

We use email internally within our large (400+ docs) physician practice and it works because there is a directory with every doc’s email address, but I don’t have email addresses for all the other doctors in the area and they don’t have mine.  I work in the hospital and there is discharge paperwork that is suppose to make it back to the patient’s other doctors, but studies have shown that the communication isn’t there 75% of the time (see previous posts).

In healthcare IT, email provides the most bang-for-the-buck to deliver value.