Thanks to my University of Colorado School of Medicine colleague Steve Ross MD who challenged me to think about how we improve the clinician experience in EHR’s.
Yes, we are all worried about Physician Burnout, and about the EHR Burden, and bemoan how difficult it is to assemble all the important pieces of data about a patient into a coherent whole, so that the physician can GROK the patient (instantly understand; thank you to Robert Heinlein’ Stranger in a Strange Land) and thus treat him/her effectively and humanely.
Let us not forget where we came from. Although paper was more familiar, and tactile, and you could SEE HOW HEAVY a patient’s past medical history was by how many volumes the clerk would deliver from the warehouse and slam down on your desk, it was NEVER a joy to approach the chart and begin to consume it, page by page.
AND YET we are still far away from the ideal state where a physician can walk up to an EHR, bring up the patient, and on ONE SCREEN have a pre-digested, specialty-specific, visit-specific, patient-centered, view of the patient. We have all dreamed of the ideal “chart-biopsy” tool that would allow us to see all the many pieces of a patient’s past history, gathered into one place. I have yet to see such a tool.
In my view, such an ideal GROK-board should pursue the following:
- Be HUMANE and emphasize the patient’s goals, preferences, and identity
- Thanks to Gregory Makoul for his fantastic work in patient-physician communication. We need to improve the visibility of patients as humans in the EHR so that physicians can more quickly connect as person to person; this results in improved patient outcomes and less physician burnout.
- Increase SIGNAL to noise ratio of the information presented
- Prioritize MOST IMPORTANT next actions
- Make the RIGHT thing easy
- Make it QUICK to grok and then act
CMIO’s take? I don’t pretend to have a monopoly on this vision. I challenge all of us to make something better than the GROK-board I threw together the other evening.
CT – excellent question, topic being “how can we build a Snap Shot or other report that will crystallize topics relevant for the current encounter?”. Two thoughts: A) we can continue to improve our data-centric reports we build; and B) your GROK board contains lots of patient-entered data. This may be the biggest challenge: how to GET this in meaningful fashion, and then how to USE it. I just saw a tech-savvy patient this AM, who also had all her questions written down on a 3×5 card. Next steps? Consider identifying a clinic with high patient-MHC use, and map out what might be better steps towards provider-patient collaboration. Thanks for asking – JS