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In my short time as editor of InformationWeek Healthcare, I've talked with many health IT leaders and clinicians and have gotten an earful about what's wrong with the current healthcare system. One impression I've come away with: The dialogue between technologists and clinicians is just not what it should be.
IT execs complain that doctors and nurses don't understand or care to understand the capabilities, limitations, and costs of health IT, while clinicians complain that IT pros don't appreciate what they need to provide effective patient care.
With that disconnect in mind, I called together two prominent clinicians to sit down with me during InformationWeek Healthcare's first IT Leadership Forum, in New York City earlier this month, to discuss possible solutions.
Charles Lockwood, MD, chair of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine and chief of ob/gyn at Yale-New Haven Hospital, provided some insights into clinicians' needs when he explained that there's not just one culture in medicine, but many different cultures, varying from specialty to specialty and even within each specialty.
Different specialists spend vastly different amounts of time with patients and have very different needs for detailed information. At Lockwood's hospitals, for instance, busy gynecologic surgeons make a lot of postoperative visits and want to roll in, look at a patient's dressing, do a very quick data check, and move on. "They're terrified that an EHR system will slow them down" or disrupt their workflow, he said. One potential solution they're considering at Yale is to hire "scribes"--typically nurses--to help the surgeons negotiate the EHR system and do the data entry for them. Lockwood's take-home message was clear: Because there are so many types of clinicians with varying needs, you can't rely on a one-size-fits-all approach to EHRs. Customization is essential.
Debra Wolf, associate professor of nursing at Slippery Rock University near Pittsburgh and a specialist in informatics, addressed the issue of customization in more detail. When she was involved in setting up an EHR system at the University of Pittsburgh Medical Center, nurses and doctors complained about information overload. The clinicians didn't want to wade through mountains of online patient data just to get very basic information, such as: How far does my patient have to be capable of walking before I can discharge him? or, What's his last blood glucose reading?
To address these problems, Wolf and her colleagues created "quick view screens" that pulled the most essential facts and figures from the EHRs so clinicians could make fast decisions. These quick screens can turn a frustrating 20-click search through nursing notes into a two-click decision.
Such practical advice was only a small part of the discussion at this month's InformationWeek Healthcare IT Leadership Forum. Our cover story provides much more. Dive in.