Electronic Medical Records and Computerized Physician Order Entry have now been broadly deployed for two or three years. Healthcare providers, both practices and hospitals should be experiencing measurable improvement in patient safety, patient recovery times, medication cost controls and other operating gains.
CPOE can present preferred generic medications as primary order options, encouraging formulary compliance by medical staff. Digital entry eliminates risk of vague or indecipherable handwritten orders. Many hand-offs and “touches” are eliminated as orders are presented in real time to nursing, clinical service teams and other physicians. Medications, diagnostic services and therapies can be initiated promptly and administered as scheduled with more precision. Charting of vitals and other patient condition information in near real time with accurate time/date stamps enables patient response to be tracked against expectations, monitoring course of treatment effectiveness with more precision and data points, so that progress trends become recognizable sooner. Medication and therapy delivery errors can be effectively eliminated with tool supported bedside verification of identity and order. Evidence based, best clinical practices can be presented and measured for utilization resulting in consistent, rigorous adoption of new treatments and therapies by all medical staff. Clinical service delivery can be measured for consistency and accuracy of practice, providing opportunities to really optimize workflows and raise performance standards. Clinical operations have become transparent to objective, credible measurement, creating increased accountability for every team and team member.
These are physical operating impacts driven by the shift from paper-based workflows to digital tools coupled with data capture occurring, literally, at the point of creation and by the creator. Clinical data and direction are immediately available to every team that needs it. Accountability is documented. There is little chance of misunderstanding or misinterpretation.
Operational effectiveness and patient risk should be improving as opportunities for incremental improvement are realized. We should now be seeing faster, safer, patient care and outcomes in increasing numbers.
What is the next level of improvement? We now have all this digitized patient information, almost too much for a physician to process and evaluate. Today’s presentations are, understandably, much like an awkward version of paper-based tools. But paper does not translate well to a tablet or phone. And paper-based presentation models cannot exploit any of the richness and content now captured digitally.
Enterprise platform tools strive to provide sound, comprehensive but essentially generic presentations. While these can serve effectively for many situations and uses, solution vendors must begin development of diagnosis and specialty specific clinical presentations which anticipate what the physician should be evaluating, providing trends, context and outcome forecasting. These sorts of services are likely to come from very specific use case SMART on FHIR apps, machine learning services and clinical “big data” repositories to proactively anticipate medical staff information requirements specific to each patient’s diagnosis and general health condition. Platform vendors should open their enterprise class products to internal and external innovation as the opportunities to positively impact physician information access, interpretation and selection are infinite. This next generation of digital services may help resolve many of the frustrations and utilization challenges medical staff experience every day. Many doctors have complained to me for years that tools require navigation and searching for relevant information when the system can anticipate the need, but it must be “pulled up”. These next rounds of innovation can help support patient care delivery with services that are proactive, intuitive and clinically relevant. They promise to restore the doctor’s ability to really focus on the patient during an encounter, enabled by unobtrusive technology.
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