Why do clinicians resist interoperability?
For clinicians, interoperability is the ability to immediately access, view and use relevant patient information, including that which exists in other systems, from their own electronic health record (EHR).
Interoperability is vital, but it remains an unmet challenge in health care. We all agree it is important, so how do we advance connected care across settings?
We must first understand a clinician’s perspective. To that end, I offer “A Day in the life of Dr. Jen:”
5 a.m. Check for newborns to see in the hospital.
5:30 a.m. Preload patients for the day. Time for coffee, the kids and dogs are up.
7 a.m. Turn on pager and leave for the hospital.
8 a.m. Interrupted for a C-section (twins!)
9 a.m. Late for clinic, 12 patients scheduled, 2 already arrived.
11:45 a.m. Called to the ED for infant with respiratory distress.
1:30 p.m. Late for clinic, 15 patients scheduled, 3 already arrived. Reception extending my day.
4 p.m. Interrupted for question about infant with respiratory distress. Did I see the labs/x-rays?
6 p.m. 7 patients added to evening clinic, another new baby to see but at the other hospital
8 p.m. Clinic patients seen, but documentation nowhere near complete. (Did I eat today?)
10 p.m. Inpatients tucked in at both hospitals, possible C-section later and still on call.
With daily schedules like this, it’s no wonder clinicians are impatient with any technology that slows them down, or hinders their access to patient information.
Top 4 clinician challenges (and how to overcome them)
We’ve moved beyond paper charts and fax machines, but technology has a long way to go to meeting clinician needs for interoperability. For a busy clinician, the top four reasons they resist interoperability include:
1. What is my password? If an application requires a separate login and password, it creates unnecessary extra steps for clinicians.
Solutions must enable immediate access from within the EHR.
2. Everything but the kitchen sink. If an application provides every patient detail ever reported into any system, a clinician could be looking at a list of 100 problems or medications, with no guidance as to how recent or pertinent to the patient’s current issue.
Solutions must enable a view of the most relevant data, and include an option to view details.
3. Siloed information. Too often, organizations stop short of integrating data from community sources. But to provide individualized, coordinated patient care, clinicians need access to patient data beyond the four walls of their hospital or clinic.
Solutions must enable a view across care settings.
4. Untouchable community data. A truly patient-centered approach enables clinicians to use community data as if they entered it themselves.
Solutions must enable adding selected clinical data to EHR.
When it comes down to it, the only reason health IT exists is so that clinicians can take better care of the patient. The solutions that enable us to diagnose and treat patients quickly, compassionately and cost effectively are the ones that will help us achieve the promise of interoperability.