The following is a guest article by Amy Heymans, Founder and Chief Experience Officer, Mad*Pow.
Electronic Healthcare Records were supposed to be the wave of the future, allowing clinicians more time to spend with patients, and offering individuals access to their personal health data. But is it working the way we intended?
Clinician burnout, and its tie to mental health, has long been a top concern in the healthcare industry. This insidious problem worsened exponentially during the COVID-19 pandemic and is threatening not only the wellbeing of clinicians and caregivers themselves but ultimately the patients in their care as well. The strain of this unprecedented emergency is piled on top of stressors that have been plaguing the healthcare industry for years, driving valuable personnel from the field.
The rise of Electronic Health Records (EHRs) should have mitigated some of this stress. One would assume that with technology at their fingertips clinicians would have less paperwork to manage, leaving more time for holistic care, making healthcare more efficient and accessible. Unfortunately, we’re finding quite the opposite. Hidden in the promise of EHRs are difficult interfaces, confusing customization options, and usability challenges.
What tech stressors can lead to caregiver burnout?
The hope in providing clinician access to health data electronically was that it would reduce errors, provide faster access to data, and improve conversations with patients. However, the most common complaint about technology is that it tends to drive the conversation with the patient, versus support caregivers in connecting with patients in a meaningful way. It also takes a huge amount of time to fill out all the required fields, which aren’t often auto-populated, and the workflow typically doesn’t follow the workflow of the clinician – preventing what might otherwise be a smooth interaction. As it turns out, technology – as it stands now – can end up worsening the clinician’s experience with the patient as opposed to improving it. In appointments that average seven minutes, filling in charts can end up steering the conversation, eating up valuable time that could be left for open discussion.
What solutions can we adopt to improve EHRs?
In some healthcare organizations, there is a feedback loop where doctors can evaluate EHRs. They are able to say, “this doesn’t make sense” or “this could be better.” That feedback can then be taken into consideration as a team of people evaluates the feasibility of changes. So, when we can design a process for clinicians to flag usability concerns it can be evaluated on whether it’s a global issue that could be addressed across the board or altered based on preference. An EHR system is not a ‘set it and forget it’ technology. It has to be experienced, tested, and evaluated by the users. Unfortunately, health systems don’t always have the bandwidth or resources to do this – especially during a pandemic.
Where do EHRs need to go in the future to fulfill their promise?
It’s not about the EHRs, or at least, it’s not about the technology itself. It’s about the kind of experience doctors want to provide to patients. What kind of relationships do they want to build? How do they want to support patients whether they are visiting the office or at home? To improve EHRs, we need to consider the relationship we want – one that builds trust – and design the technology to support that relationship. Achieving this kind of change can feel like trying to make a sharp turn on a cruise ship. We need to rethink how things are getting accomplished, but that doesn’t mean we can’t use the infrastructure that’s already in place.
EHRs and health systems must truly fulfill the promise of accessibility. Part of the reason for mandating the use of EHRs was to make it possible for patients to go from one doctor to another, whether inside the same health system or outside and carry their personal health data with them. Open-source health access is an important wave of the future, and it won’t be possible until we can successfully manage data in a meaningful, safe, and accessible way. Widespread, patients in the US still don’t have access to their personal health information. They can log into a portal to look at it, but often can’t seamlessly move it from one doctor to another, store it locally for themselves, upload information to it, or make a correction to the data. In a world where the internet and technology have transformed the way the world communicates, moving patient health records still often involves faxing, a nearly obsolete technology that takes a lot of time that could be dedicated elsewhere. This is detrimental for clinicians because they aren’t getting the data they need to do their job to the best of their ability, and for patients, because it makes moving around the health system more difficult.
The future of healthcare:
We must always strive to put the data and the power to access it in the hands of the patient, enabling them to share it easily with whomever they want, whenever they want. So far, EHRs have fallen far short of that goal, but there is still hope that with continuous focus on design and innovation, we can help EHRs deliver on their promise to improve the healthcare experience.
The challenges of EHRs continue to frustrate clinicians and patients alike, and there is no doubt that inflexible technology can contribute to burnout. That doesn’t mean that EHRs are a failed technology – There is still progress to be made in designing them so they truly enable strong relationships between patients and their care team. Innovators across health, technology, and design can collaborate to create solutions that deliver on the promise of providing better care.
About Amy Heymans
Amy believes that design can help improve the human condition. It was with that mission and vision that she founded Mad*Pow in 2000. Amy plays an essential role in Mad*Pow’s visualization of a changed healthcare system in the United States. Her work with companies like Aetna, CVS, McKesson, and Fidelity has helped them improve the experiences their patients and customers have with them, leverage design to drive change, and facilitate human-centric innovation. For the last 11 years, Amy has been the driving force behind the Health Experience Design Conference (HXD) and she has successfully connected and networked disparate parts of a challenging and siloed system.
