By Jason Rzutkiewicz, September 25th
In the 1970s, the federal government “began using EHR … with the Department of Veteran Affairs’ implementation”. At that time (1975) physicians spent on average 60 minutes with every new patient that visited their office.
Today, physicians spend a mere 12 minutes with those patients.
And yet healthcare as a percentage of GDP has exploded (from 8% to 18%)!
How did we get here?
For starters, EHR was not designed with the patient or the sician in mind. In hindsight its primary purpose was to support billing and administration. It is often referred to as the intruder in the room as patients and physicians interact. Physicians are often now forced to be more focused on screen time than patient time.
This starts to speak to the cumbersomeness of these systems. Training new physicians to use EHR is a 20hr + experience.
As Eric Topol shares in his recent book Deep Medicine, 80% of new notes in EHR systems are copied and pasted from a previous entry. The electronic health record has turned physicians into data entry technicians with more time spent tending to the keyboard than the patient.
Clearly physicians see limited value but are forced to adhere creating a “lose-lose” situation.
Physicians were passive while major new changes took hold in the business of healthcare like EHR (along with managed care, HMO’s and others). They know full well that their ability to listen and engage have been severely compromised.
In hindsight they missed an opportunity to be better advocates for themselves and their patients.
So where are we today?
There is tremendous pressure on physicians time. This is leading to burnout and depression (doubling the risk of patient safety). “Shallow medicine” is taking hold. The path of least resistance is often being chosen which is leading to over diagnosis of conditions, procedures and surgeries.
The implications are vast, including driving inflated healthcare costs and even playing a role in the opioid crisis the nation is facing today.
But the role of EHR today is more important than ever. It is positioned to play a critical role in enabling AI to drive better health outcomes for all. But that depends in large part on meaningful physician adoption and engagement.
Otherwise garbage in, garbage out will compound the problems we’ve faced over the last 40+ years.
The next generation of EHR
How do we create the next generation of EHR?
One that starts with the patient, the physician and their needs — to truly connect with each other — at the core.
And for physicians, how do we ensure that as we move towards a world of AI assisted care that they don’t make the same mistakes as they did with EHR?
The opportunity is now to ensure that the productivity gains from AI are reinvested into more time with patients rather than more schedule slots on the calendar.
About the Author
Jason Rzutkiewicz is the Client Engagement leader at YML, playing a vital role in helping brands navigate the complex digital landscape of mobile, social, search, and data and bridging them with physical spaces to create seamless experiences.