Changing the Physician Experience with Technology

By Paul W. Brient, President & Chief Executive Officer, PatientKeeper, Inc.

The interaction between a physician and a patient is the cornerstone of the healthcare delivery system. Although healthcare information technology (HCIT) investments have brought great efficiency to most healthcare processes, physicians have not directly benefited from these investments. In fact, this automation has had the opposite effect in some cases.

Physicians often need to access many systems throughout the course of their day, slowing them down and requiring them to make decisions with less-than-complete clinical information about their patients. The Physician Information System is a ‘last mile’ solution that delivers information to physicians from multiple HCIT solutions and automates a physician’s day. Automating the physician workflow – across all locations and care settings – not only saves time for physicians, it also allows them to focus on patient relationships, provide more responsive care and contribute to improved hospital performance.

Traditional approaches add complexity

HCIT investments to date have primarily centered on the automation of processes and places. Most hospitals have laboratory, pharmacy, radiology and pathology systems. Increasingly, hospitals are deploying picture archiving and communication systems (PACS), electronic medication administration and nursing documentation systems. Clinical systems are finally coming to the ambulatory world with the recent push for ambulatory electronic medical records (EMR). These systems have made major improvements in core processes and patient care.

However, there has been an ironic side effect of this automation: in many cases, it is now more difficult and complicated for physicians to access clinical information. Before this automation, a physician simply needed the paper chart to access all the information for a given patient. In a highly automated organization, a physician may have to access several different systems to gain a complete view of a patient. Even worse, physicians practicing at multiple hospitals have to work with multiple systems, with different user interfaces, different metaphors, different user IDs and passwords. Furthermore, many of these systems are not easily accessible outside the four walls of the hospital. Given this technology environment, it should not be surprising that physicians have not embraced today’s version of healthcare information technology.

Many hospital executives are frustrated with their physicians’ adoption of technology. To improve this adoption, they have focused on improving the particular systems they have deployed, thinking ‘If I just get a better HIS or a better PACS, maybe physicians will use it’. This is unlikely to solve the problem since it really isn’t the root cause.

Single point of access

A different approach is required. We must look at a physician’s care delivery process like any other process we have automated and develop a system that automates it – not in any one location or one setting of care, but across all locations and settings of care. Accomplishing this requires a new logical layer in the HCIT hierarchy. It calls for a system that overlays the existing process – and place-oriented systems – connecting physicians to all patient information from a single user interface that is accessible wherever they are during the day: a Physician Information System.

Implementing a Physician Information System would allow hospitals to improve their physicians’ experience with technology – without replacing or changing existing systems. This system would not be a system of record, and patient records would continue to be managed by the system at the place where the patient receives care (e.g. hospital, clinic, ED, practice). For the hospital with a Physician Information System, core HIT systems continue to function as they do today. The only difference is improved physician satisfaction with them. No physician complaints, no need for nurses to print results and less reliance on the paper chart.

This ‘last mile’ solution is necessary for hospitals to truly monetize the last 20 years of technology investments. As the cornerstone of the healthcare delivery system, physicians are key to the next round of automation. More tactically in competitive environments, hospitals with technology solutions that save physicians’ time rather than slowing them down, gain the competitive advantage of physician satisfaction.

SIDEBAR
Physician information system value

Saves physicians time and improves workflow
Provides immediate access to all clinical data for all a physician’s patients
Saves 30-60 minutes each day

Increases revenue by 8-20%
Eliminates lost charges
Reduces charge lag by 90%
Improves billing accuracy

Cost containment
Reduces physician demands on nursing staff
Reduces transcription cost