Friday, November 18, 2016
An open letter to all health care information technologists and regulators
Dear health care technologist or regulator,
The world of health care is changing exponentially. Speaking as one the nation's over 800,000 physicians, I can confidently say that most of us understand the fact that the current health care system is unsustainable, and can't carry on as is. There are many potential solutions to explore, and everyone in health care needs to try to come together in an attempt to address these problems and determine an appropriate future direction.
One of the biggest changes to physician practice over the last decade has been with regards to our interaction with information technology. The need to expand the use of technology in health care and bring it into the 21st century is understood, and of vital importance as we seek to improve quality and care for our patients. The government's Meaningful Use program, initiated with vastly increased health care information technology spending as part of the Federal Stimulus Package in 2009, gave health care organizations and individual physicians large financial incentives to expand their use of information technology at the frontlines of medicine. But alas, the software solutions available to us were not yet ready for primetime, and have caused something of a disaster for the practice of medicine.
Simply put, you need to understand that they simply take too much time to navigate and use. Studies are now showing that doctors (and nurses) are spending an absolute minimal amount of their day in direct patient care, with the majority of the rest staring at a screen and clicking boxes. You have to realize that most of us in health care chose our profession because we want to interact with our patients and spend the bulk of our day in direct patient care. The effect of having to spend excessive amounts of time documenting and performing data-entry tasks contributes hugely to burnout rates and negative job satisfaction. Furthermore, it is a huge waste of education, talent and resources. As for patients, most of them are increasingly frustrated by their ever-decreasing time slots with their physicians, and the fact that a lot of the time, their doctor is just staring at the screen rather than looking at them.
We understand that electronic medical records do bring huge benefits in terms of being able to find and retrieve patient information. They are definitely the way of the future, but we are nowhere near where they need to be.
The American Medical Association and other specialty societies have previously called for significant improvements in the usability of Electronic Medical Records for at least the last couple of years. We at the frontlines have been patiently waiting, but these improvements are yet to materialize. It is therefore now time for a massive call to action for the world of information technologists and regulators to work with doctors on designing vastly better information technology solutions, reducing bureaucratic burdens, while keeping in mind that health care is all about humanity and direct patient care. Nothing short of a major overhaul is required. This will not only improve quality and efficiency at the frontlines, but also most importantly, make our patients happier too.
Suneel Dhand MD
Attending Physician, Internal Medicine
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.
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Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.
Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.
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Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.
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Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.
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Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
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