Earlier this month, I shared a discussion that I had with EMC Certified Solution partner, Fortrus, around the UK’s EMR Rollout talking about some of the infrastructure challenges in Healthcare. Today’s blog comes from another EMC Certified Solution partner, Lutech, with four key suggestions for successful EMR implementations, starting with getting doctors on board.
EMR: Getting Doctors On Board
Matteo Tiberi, Lutech
Since 2002 Matteo Tiberi has pioneered cutting-edge medical information systems, culminating with Lutech’s wHospital, the first Web-based EMR solution
I hear the objections every day:
“I’ve worked the same way for 30 years. Don’t ask me to change.”
“I can’t waste hours filling out complicated electronic forms.”
“How do I treat my patients and type on a keyboard at the same time?”
It’s not surprising that many doctors continue to have serious concerns about Electronic Medical Records (EMR) systems. Some see EMR as a distraction, an intruder in the examining room, an extra master to serve, a demanding overlord that claims to offer benefits but actually eats up precious time, sometimes doing as much harm as good, if not more.
It doesn’t help that the first major attempt at EMR migration went poorly. The failure of NHS IT in the UK has left a bad taste.
By law and necessity, EMR is rapidly becoming a fact of life. Done properly, EMR solutions can bring significant efficiencies, enhance patient care, reduce or eliminate dangerous errors, and open up undreamed-of possibilities.
Nevertheless, doctors’ concerns are real and must be addressed. That’s done in four steps:
Begin With The Right Premise: When designing an electronic system, we’re not simply building a recordkeeping apparatus. We’re creating a medical device. This cannot be emphasized enough. EMR should be viewed primarily as a tool to help clinicians do their jobs more effectively. Anything that works against that premise or slows it down needs to be engineered out, because errors and delays in this arena cost more than money.
Eye of the Doctor: No medical instrument company would design a new scalpel or heart monitor without talking to clinicians first. Same with EMR. We must communicate. Do doctors prefer marking up checklists or writing freely in narrative form? Give them both. Do they find some forms maddeningly generic and others too narrow? Dig deeper. Broaden the horizontal and vertical base to include as many scenarios as possible. Do clinicians want access to a patient’s total information, as well as the ability to call up just the required parts for a particular task? Do it. Are they clamoring for varied templates so a pediatrician treating a 5-year-old need not fill out mandatory forms about STD’s? Fix that.
Make It Worth Their While: Tailor any EMR solution not only to assuage concerns, but to solve real problems. No doctor wants to spend an hour-plus drafting a patient’s discharge letter, painstakingly collecting all the required details from a multitude of paper notes. A well-crafted EMR built to properly store, retrieve and re-use critical data can do the job in minutes. Even better, make the electronic solution as easy to use as paper. Put it on the Web, on tablets, on smartphones, so anyone who needs and uses it can take it anywhere… including the patient’s bedside.
Get Real About Risk: No system will ever be totally foolproof, hack-proof or error free. Be honest about that. But make sure every EMR incorporates the most robust safeguards, security protocols and alert systems available. Then pose a simple question: Would you stop using your credit card because of a bank error? We’ve learned to accept a degree of uncertainty when the benefits are too great to give up. Yes, a medical error is a whole different thing. But paper is also prone to error. And the potential life-saving benefits of a smart EMR are also too large and too important to ignore.
What is your experience with moving the healthcare industry forward to new information systems?