The Professor
Last week I presented at the Entrepreneurship@Cornell Celebration and gave a brief account of the history and challenges of our start up. A chance encounter with a distinguished professor in the crowd alerted me to some important research. Below is the story
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After my symposium session last Friday morning I was approached by a distinguished, professorial looking gentleman (the bow tie was the tip off). Lo and behold he was a professor. His name was William White and he happened to be the head of the Cornell Sloan Health Policy program. He stated that he enjoyed the story of our start up journey -flattery always works. And he picked up on a point that I had made in my talk as being a driving force in our venture.
That point was that health care information technology (IT) often hinders communication instead of improving it. And nobody is quite sure whether IT makes health care delivery more or less productive. It seems so intuitive: computerizing records should make them safer, more efficient and more productive. But that depends on how you define productive. Productive for whom?
I would define productive as any activity that ultimately leads to improvements in efficiency and delivery of patient care and satisfaction. Anyone who’s been a patient knows that it’s possible to get lost in the system. The system is just so complex. Health care, however is still about human to human interaction. Patients want face time with their caregivers. It is part of the healing process.
To the extent then, that EMR’s improve that human to human interaction, they are good. But there’s the catch. They do often interrupt the interaction. For example, if a doctor used to be able to write his note in 2 minutes and it now takes 5 with the EMR, those 3 minutes are potentially shunted away from true human interaction.
I’d like to thank Professor White for alerting me to 2 interesting articles that hit on this point. You can check them out for yourself if you want here and here. I’ve summarized a few of the salient points below:
EMR’s are not all good or bad. They do add unique changes to the clinician patient interaction that at times improve care and at times hamper it.
How they work well:
-they allow clinicians to rapidly access reports and data in their office
-they can link to scheduling and billing systems and better coordinate the two processes
-they make medication look-up, easy
-they can code in automatic reminders for clinicians
Where they are lacking:
-data overload. Cutting and pasting and template formation encourages overly verbose records. Finding the needle in the proverbial information haystack may slow record review
-record keeping becomes a billing exercise. Many EMRs are designed around maximizing billable charges by allowing clinicians/ hospitals to hit coding “bullet points.” The system becomes divorced from the patient care and revolves more tightly around patient charges. The two are not equal
-Interoperability between systems is poor. Clinicians are forced to fax records anyway
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Bringing it back home… At TouchConsult we’re all for technology. But we’re advocating technology that works within the natural rhythm of the of the doctor patient relationship; technology that encourages more human interaction and better communication. We’d like to see more companies tackle the health IT problem from this angle. We believe that the market will eventually move this way. And we’ll do our best to help push it in that direction.
