Has anyone seen my Dictaphone?

Wednesday, October 22, 2014 | Ginger Biesbrock

As a healthcare administrator and clinician, I have seen a world evolve from very simple to quite complex when it comes to ambulatory operations, acute care operations and patient care flow. Ten years ago, I could hand a cardiologist a dictaphone and a pen and he/she could see patients in the office, read imaging studies in the testing center, perform procedures in the cath lab and round on patients at the hospital. The most recent practice that I worked at had two different EMRs, one for the hospital and one for the office.We had a software template reporting application for imaging and another software template reporting application for procedures in the cath lab.Our providers were expected to place all of their own orders in both EMR systems as well as perform full documentation of their patient encounters in both EMRs.And we expect them to maintain full productivity, patient experience and quality/safety of care?And stay happy?

A study of physicians across the country released in 2013 “Factors affecting Physician professional satisfaction and their implications for patient care, health systems, and health policy,” found the EMR usability represented a relatively new, unique challenge to physician professional satisfaction.And we are asking our cardiologists to use four of them?Common complaints included poor usability, time –consuming data entry, interference with face-to-face patient are, inefficient and less fulfilling work content, inability to exchange health information and degradation of clinical documentation.The same study also noted that the higher number of functions that an EMR provided the less likely to have high overall physician satisfaction.Poor satisfaction threatens effective usage; patient experience and I would argue potential safety, quality issues.However, when used well and implemented well, an EMR can be a very powerful tool with easy access patient information, clinical decision support tools, and quality measurements.I do not suggest we return to the days of the Dictaphone.

As healthcare administrators, it is important to keep our focus on our primary objective, providing great patient care.As we embark on continued development of technology that inherently offers access to information, continuity of patient care, population measurement, care team communication, we need to be deliberate about how we operationalize our technology to make sure that it actually provides those pieces.Interestingly, the very assets that the EMR is to provide, was also found to be a dissatisfier as the assets have not materialized in some cases.It is not enough to ‘roll-out’ an EMR but rather to take the time and resources required to develop workflows that make sense and enhance the EMR technology.I have said many times that “Our EMR should work for us, we should not work for it”.  So the next time your provider asks you where his/her dictaphone is, take the opportunity to review your technology and your workflows.Are they effective?Are they working for your providers and patients, or are they working for the technology? 

 

 

 

---