Do the Easy First

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 - Lyle Berkowitz, MD
Lyle Berkowitz, MD

I love reading about advanced technologies that have the potential to help with our most complex patients. It will be a fantastic future where natural language processing mixed with big data analytics will help diagnose difficult cases and suggest novel management strategies.

A future where Google Glass will help doctors more easily recognize dermatological manifestations of systemic diseases while also providing patients with a video of their visit to the physician. And where a nanotechnology sensor floating in the bloodstream can identify DNA changes related to early cancer or heart disease and send an alert to let patients and their providers know to start intervention quickly.  

However, I am also a pragmatic physician and know that while all of this may eventually happen, I have to live in the here and now of technical and financial limitations. Currently, we still struggle to get reasonably accurate data into EMR systems, doctors are not paid extra to identify anything early and most physicians feel they are running out of steam as they spend half their time doing non-clinical, or certainly non-advanced, duties.  

I believe some innovators need a wake-up call. Instead of focusing all your time trying to figure out the hardest and most complex issues, how about figuring out the easy stuff first? For example, many physicians spend a big chunk of their day documenting what they just did, filling out administrative paperwork, trying to keep everyone up to date on preventive care and disease management protocols, and answering the same questions over and over again.

In other words, physicians are not being used at the highest level of their abilities and, thus, we have created an artificial shortage of doctors. Furthermore, physicians are not great at taking care of all this routine care and administrative paperwork, resulting in decreased quality and patient satisfaction. It’s no wonder our healthcare system is the costliest and not the most effective in the world. 
 
But who says doctors should be doing all this work? State laws on scope of service need to be respected (or at some point reviewed for best practice). But ironically, the current use of IT has often shifted more work onto the physicians than ever before due to poorly created IT systems which were built for a physician-centric setting rather than a team-based setting.  

What if we started applying our innovative technologies and thinking to help streamline the routine and repeatable workflows which clog up a physician’s time? What if we could use automation to cut down on the unglamorous paperwork chores which are slowly strangling our physicians? What if we used HIT to empower a physician’s team to manage a large chunk of their stable patients remotely based on the doctor’s electronic care plan? What if we saved physicians one, two, even four hours a day of this drudgery so they could spend that time focusing on their truly complex patients? What if we could have a future where care could be delivered in a safer, cheaper and more efficient manner and doctors could focus their time on tasks for which their abilities are best matched?

Maybe they’d even have some time to try out that new Google Glass!