Swapping physician screen time to patient face time

Physicians are becoming more time constrained as documentation regulations and requirements surface. Drop down menus and check boxes only bottleneck the patient’s story and physicians are tasked with how to accurately tell their story. As technology increases, some tools can be leveraged and optimized, however, some only create more challenges. At the end of the day, the clinician cannot spend enough time with each patient. It’s time for that to change and for medicine to become patient-centric again.
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Clinicians implementing better technology solutions to improve notes and spend more time with patient

When I see a patient, I try to give them my undivided attention, looking, listening, evaluating hundreds of small nuances as well as bigger signs to  properly understand what might be going on and more importantly how to  fix it. Unfortunately, there is too much being pushed into that short visit, which is usually under 10 minutes.  Physicians everywhere are facing the same strains whether they’re working in a busy trauma center or a private practice in the suburbs. Isn’t it time for that to change?

Physicians are being asked to provide peak-performance as caregivers, but also be data-entry clerks, and coding experts, all while being more mobile and time-constrained than ever.  Limitations such as check boxes and drop down menus take time and often deliver blanket statements that don’t really give physicians the information we need. If a physician upstairs reads a chart on my ER patient they want to know what I thought, and my recommendation. They don’t get that when technology gets in the way.

The following comment sums up the problem we want to solve: 12 patients seen, 1,233 mouse clicks. It’s time to ease physician frustrations and move from implementation to optimization of technology. Many of us helped hospitals install EHRs, and supported adoption efforts from day one as physician champions. Now it’s time for physicians to reap the benefits.

We need an easy way to create rich patient notes in the system and get information back out of it, all while focusing on patients. We need help adhering to evidence based guidelines and we need to see the whole picture of the patient without an archeological dig. Too often the details of patient’s clinical needs are trapped in structured data that create ambiguous notes and leave clinicians wondering, “What’s really going on with the patient?” With more date entry, more regulatory requirements, more penalties, we are stretched too thin and spend 43% of the day on computers. Patients and physicians are the biggest losers.

Fortunately for me, I’m into gadgets. I tested Google Glass, I use a lot of apps to save time in the ER, anything to preserve time while delivering better care.  I latched onto speech recognition early as a way to dictate notes in between patients, and even created all kinds of shortcuts and libraries of commands I’ve shared with my colleagues and physicians across the country over the years. That has certainly saved time and provides a richer patient note for providers to use, but the harsh reality is all these data fields and regulatory requirements in healthcare are still winning.

 

Turning the corner

Now that we’ve gotten past adoption of technology like EHRs and computerized physician order entry (CPOE), it’s time to capture some real benefits for providers, and deliver a solid answer to the question: “What’s in it for Me?” (WIFM).

  • For patients that involves healing, better outcomes, relationships with their providers and information available that is easy to get and understand.
  • For physicians this involves better outcomes, access to data, time back in their day, tools to crunch data, help practicing evidence-based medicine, mobility, and access and communication with other physicians.

Patient and physician satisfaction come hand in hand. Let’s improve the patient and the physician experience by swapping screen time with patient face time, and leverage these tools and technologies to increase the list of things clinicians can stop doing to make room for that face time.  Now that much of the hard work is done, it’s time for physicians to see the original promise of electronic medical records – improved quality, efficiency and care coordination.

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About Dr. Reid Conant

Dr. Reid Conant is a chief medical information officer for Nuance’s Healthcare division. Dr. Conant has provided medical direction and leadership to his hospital through the deployment and optimization of CPOE and physician documentation solutions. Prior to Nuance, Dr. Conant served as the president and founder of Conant and Associates, Inc. which was acquired by Nuance in 2014. For more than eight years, CAI assisted well over 200 organizations, and trained over 10,000 providers on physician documentation solutions. Dr. Conant is an actively practicing board-certified emergency physician and Chief Medical Information Officer of Tri-City Emergency Medical Group in Oceanside, CA. He earned a B.S. in Animal Physiology and Neuroscience at the University of California, San Diego and earned an M.D at Jefferson Medical College of Thomas Jefferson University.