Electronic Medical Record (EMR)

At some point in all of our lives, each of us has been a patient. Each of us has faced the benefits, trials, and tribulations of getting care, but very few of us have stood in the shoes of our physician. So, let’s take a look at what it can look like to be a doctor using an EMR system…

First, let’s talk about change. Most of us have undergone frustrating change at work. A change of leadership, new regulations or a new kind of copy paper. But how many of us have undergone a full up-end in our workflow process?

Widespread adoption of the Electronic Medical Record (EMR) system as the new way to organize and store patient data began in 2014 (//bit.ly/2NNghtd), prior to this time processes were largely paper and pen and manually filed.

As of 2015,

This process changed the way medical staff stored and communicated data and while there has been shown to benefit from the shift, the process was long and arduous. Remember that time you had to use Excel for the first time, yeah like that, times 100. Additionally, this change came along with a slew of new regulatory guidelines and reporting rules.

So how has life, post-EMR implementation? One study found that:

  • Physicians spend 49.2% of their time doing paperwork and EHR work
  • Physicians spend 27% of their time with patients.
    • 37.0% of this time with the patient was doing paperwork and EMR work (//bit.ly/2MBRXpG)

With so much time being dedicated to working, physicians are on a tight schedule to maintain their patient load and their desk work.

So how often does this schedule not work out as planned? One study found that:

  • 75% of physicians fall behind in their appointment schedule at least once a week.

Of this 75%:

  • 79% said that the reason for falling behind was that they spent more time than a single visit time allotment with patients.
  • 66% said the reason was that patients were late or didn’t have time to fill out the paperwork.
  • 49% spent time between appointments recording notes.
  • 78% said that appointments are booked too tightly together or were overbooked.

When asked, physicians listed things that they believed would improve their efficiency:

  • 43% said better technology
  • 38% said more non-clinical staff
  • 29% said fewer patients scheduled
  • 19% said more administrative staff (//wb.md/2Ni7joa)

The healthcare system as we know it has numerous opportunities for improvement across the board, but it is important to understand the challenges facing each participant. A collective understanding moves us closer to being able to stand in each others’ shoes and work together to improve the healthcare experience at every level. 

To learn more about how cliexa is solving these problems, download our FREE PDF on Chronic Care Management, and how to streamline clinical workflow.

STDs are a persistent enemy
STDs are a persistent enemy

…Jonathan Mermin, director of the CDC’s National Center for STDs and TB Prevention, said in a news release last month. He added that the epidemic is, “…growing in number, and outpacing our ability to respond.” Over 50% of new cases of STDs occur in young people ages 15 – 24, Chlamydia cases the most prominent. Front-line defense–primary care clinics and overloaded physicians. They may feel they do not get honest answers or they don’t have time to ask difficult questions. Young people are not comfortable with face-to-face discussions about reproductive health.

Some physicians don’t know how to broach this sensitive conversation, “This is an awkward topic, especially for men and they avoid having these conversations. cliexa-OPTIONS gives male physicians and clinicians a tool to get through the awkwardness …This epidemic impacts females more because they are left holding the bag.”   So is it a lost cause? No, digital health offers promising solutions.

Why is Primary Care so Important?

Leveraging long-standing relationships with pediatricians and family physicians–an underutilized strategy on the front lines of this devastating battle, helps youth stay healthy. Young people respond to authentic conversations with people they know and trust.  Primary care screenings identify most new cases of Chlamydia. That’s where the cliexa-OPTIONS App, an innovative digital health technology,  plays a crucial role.

cliexa-OPTIONS reduces the cognitive load for clinicians by creating a structured report using our unique scoring algorithm. Our measures are more sensitive to cultural trends young people experience. Three levels of high risk allow tailored, pinpointed conversations that count. Our recent clinical pilot confirmed the benefits of the OPTIONS App.

Risk assessment quality was average before piloting the cliexa-OPTIONS App. After implementing cliexa-OPTIONS, physicians rated the quality of their sexual risk assessment as excellent. The cliexa-OPTIONS App improves reproductive health counseling by “making it easier for my patients to discuss what is REALLY going on with them.” Physicians said the App saves them time and all participants reported that cliexa-OPTIONS supports early identification of youth at highest risk of acquiring an STD.

Positive ROI increases revenue improves quality, tracks efforts, and supports better outcomes for young people. What’s not to love about the cliexa-OPTIONS App?? To find out how to get started, contact the cliexa team.

The status of physician digital health use

Digital health refers to the use of information and communications technologies to exchange medical information. The intended uses vary, but typically focus on improving outcomes, convenience and workflow, lowering costs and improving the doctor and patient experience, engagement or loyalty.

There are many different kinds of digital health technologies used to accomplish different intended uses, and , consequently, the rates of adoption and penetration by doctors therefore varies depending on which technology is being measured, for example, for example real time telemedicine v store and forward telemedicine v remote sensing.

Here’s how I slice and dice the industry:

1. Remote sensing and wearables

2. Telemedicine

3. Data analytics and intelligence, predictive modeling

4. Health and wellness behavior modification tools

5. Bioinformatics tools (-omics)

6. Medical social media

7. Digitized health record platforms

8. Patient -physician patient portals and consumer experience

9. DIY diagnostics, compliance and treatments

10. Decision support systems

11. Population health

12. Workflow improvement

Here are some basics about dissemination and implementation science.

Here are the ABCDEs of technology adoption.

The present status of doctors using these products and services looks something like this:

  • 40% of physicians believe that utilizing digital technologies to keep track of and communicate with patients will lead to better health outcomes.

 

  • 47% of physicians who owned a smartphone used the device to show patients images and videos.

 

  • More than 33% of doctors recommended their patients to utilize mobile health applications.

 

  • More than 20% of doctors have integrated and utilized secure messaging platforms to speak to their patients.

 

  • More than 20% of physicians monitored patients remotely with an average oversight of 22 patients per month.

 

  • Nearly half of 250 surveyed doctors are not prescribing mHealth apps to their patients due to the few regulations and mobile security policies in place within the mobile health sector.

Overall, 33% of physicians surveyed said they were using some form of telemedicine and another 29 percent said they were planning to, making a total of 62 either using or considering telemedicine, defined as “care via telephone, video visits, web cam visits – or other consultations not in person”.

However, when practitioners were asked “[d]o you have a mechanism to get paid for telemedicine services — are you in a network that will reimburse for that?”, only 19 percent said yes.

Just 18% of hospitals participating in a survey always use PROs (patient reported outcomes) as part of the care process, although an additional 72 percent said they are working on integrating patient-provided data into their routines within the next three years.

Among the organizations that are using PROs to some degree, 59% engage in chronic disease management and 58% utilize the data for surgical interventions and post-surgical patient tracking. Just over a quarter of providers focus on the use of PROs for mental healthcare, while 22% use the data for treating and managing cancer patients.

Here are some health technology gaps.

Here’s why telemedicine has not reached the tipping point.

Measuring digital health adoption and penetration will vary, of course, on who you sample and how. For example, the digital health practice patterns of a two person independent, rural general practice will probably vary substantially from that of an academic surgical or medical specialty group practicing tertiary referral medicine with backing of a large integrated delivery network budget. BIG MEDICINE, and arguably, their digital health needs, is different than small medicine.

For digital health to cross the chasm and reach wider adoption and penetration, the rules need to change, trust levels need to rise and entrepreneurs need to get smarter about when to use a given technology for an intended use where there is a clear pain point that begs for a solution.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs, and the CMO of cliexa.