There’s no room for technology in end-of-life care decisions

As a gynecologic oncologist, I care for women who are dealing with various stages of cancer.  From initial diagnosis through to surgical therapies, chemotherapy treatments and even end-of-life care, my job is to listen, assess and provide educated decisions that ultimately impact the health and wellness of another human being.  And that’s exactly what I went to school to do and precisely what gets me out of bed every morning.

As healthcare has evolved and technology has become more prevalent in the patient care process, doctors have begun to integrate technology as a tool to drive communication with the patient.  Still, it’s my belief that when talking face-to-face with a patient about a care plan aimed at eradicating their body of a disease that threatens to take them away from their family, there’s no room for paper, computers and/or mobile devices.  In these most intimate of conversations, the focus has always and must remain on the communication between the caregiver and the patient on the receiving end.  That, in its purest essence, is what practicing the art of medicine is truly all about.

That’s not to say that there’s not a place for technology in our practice.  Technology, when used effectively, can in fact allow doctors to spend more time caring for patients.  One of the things I’ve noticed with the transition to electronic health records and the move toward value-based care, is that amount of time and resources that go into actually documenting patient care can become a job in and of itself.  While documentation is critical in providing quality patient care, the amount of time it takes to fully capture the patient record and critical details needed to meet regulatory requirements can be daunting.  And let’s face it, after a full day of caring for patients, the last thing any doctor wants or needs is another two-three hours of documenting from home.  Whether people are willing to accept it or not, we’re people too – people with families and soccer games and hobbies – and we need that two-three hours to reboot for the coming day so that we can provide the first-rate care each and every patient deserves.  And that’s why our practice has turned to technology to help streamline this critical documentation process.

Today, a lot of what we’re seeing with EHRs are attempts to derive workarounds – like copy and pasting capabilities – aimed at driving efficiencies in documenting.  Why?  You guessed it, so we can spend more time with our patients.  Nonetheless, these type of cookie-cutter notes don’t necessarily positively impact patient care.  What impacts patient care when it comes to documenting is the following:

  • The ability to easily retrieve the most recent and relevant information about a patient without having to dig through pages of information,
  • Anytime, anywhere access to patient information – from mobile device to PC and in between,
  • Near real-time availability of the patient note so insight is shared across the care team in timely fashion.

I’ve been a doctor for 30 years and over that time, I’ve experienced enough change to force some of my colleagues into early retirement.  Still, I’m a firm believer that change is good and that all of the technological advancements facing healthcare today offer a glimmer of a learning healthcare system; a system that’s intelligent and focused on patients – not payments.  Is technology perfect?  No.  Does it hold promise when it comes to the creation of a smarter, more efficient approach to patient care?  Undoubtedly.  As doctors, we must always remember that despite initial hurdles related to technological advancements, there has and always will be an “art to medicine as well as science” and that it is our job to keep the patient on the pedestal where they belong.

About Dr. Edward C. Grendys, Jr.

This was a contributed post by Edward C. Grendys, Jr., MD, FACOG and FACS, Florida Gynecologic Oncology. If you are interested in reading more about topics like this, please find much more in our healthcare section.