Integrating health IT with effective and efficient patient care delivery has not been an easy process. As a recent Harvard Business Review blog points out, “[T]he [electronic health record], which was in part meant to liberate physicians from the drudgery of paperwork, instead became their chief oppressor.”1Today, looking for notes in a patient chart and copying or faxing documents has been replaced with file searches among multiple information systems and emailing requests for access to patient documents, with fingers crossed that the document will open when it arrives.
In the opinion of many providers, the shift from analog paper to digital documentation has not been liberating, and has increased the amount of time spent processing patient information and decreased time spent with patients. Unlike the growing consumer satisfaction with technology, providers’ overall satisfaction with health IT has declined over time. In 2010, 61 percent of physicians surveyed by the American Academy of Family Physicians reported being either “satisfied” or “very satisfied” with their EMRs. In 2014, that percentage dropped to just 34 percent.2
But with countless hours and millions of dollars already invested in electronic health records (EMRs), the healthcare industry has no option save a return to a paper-based system, and providers have been forced to adapt without any perceived benefit. As the authors of the study referenced above put it, “From the physicians’ perspective, it appears that the significant investment in EHR systems over the past few years … is failing to offer significant returns. Far from helping physicians to operate efficiently and have more time to spend with patients, the opposite appears to be the case.” Before, doctors took notes at the bedside with paper, pen and clipboard that were permanently saved in a patient’s file. Today, they still scribble notes on paper and then dash to a computer to type them in, sometimes losing important data in the process.
Radiologists are similarly handicapped by multiple proprietary and specialty picture archiving & communication systems (PACS). Instead of hanging files in front of a light board and talking them over with referring physicians and patients, radiologists ply their trade alone in rooms populated with the hardware of dozens of PACS. They roll between monitors, opening a different user interface at each PACS to read images, write or record reports and send them to colleagues, a practice called “swivel chair workflow.”
The initial push to adopt EHRs has shown that it’s going to take more than technology to reap the benefits of digital health. Today, the industry’s focus is shifting toward adapting technology to physician workflows, instead of telling providers to adapt their workflows to technology. Focusing on supporting the workflow needs of providers and eliminating time-wasting tasks may finally unlock the promise of digital health: Improved care coordination and lower costs.
One path to bringing health IT and efficient physician workflow together is liberating patient data from proprietary information systems and allowing it to flow freely across all types of devices, including smartphones, tablets, laptops and workstations, from any and all locations. Mobile access to patient data not only meets provider needs; it’s also essential for healthcare institutions to remain competitive. Simple, secure access to patient images, for example, eliminates the need for repeat imaging, saving both time and money.
Providing mobile interoperability and access is complex, touching on everything from security to data formats to networking technology. The right architecture for the changing care delivery environment must support one-to-many interactions. With the “one” as a healthcare provider’s image viewer, the “many” can combine:
- Smartphone, tablet, laptop or workstation: Viewing needs to be supported across all platforms, whether fixed or mobile, because providers move between them depending on whether they are at the bedside or in the office working on a report.
- Internal provider networks or external access points to internal networks: Effective workflows need safe, secure access to patient images and data, both locally and externally, so providers can coordinate care with patient care teams and specialists.
- Any DICOM or non-DICOM file, including photos, PDFs, and videos: Customers need to access not only patient scans but also photos, reports and even videos associated with either the scans or the patient. By supporting multiple file formats, a mobile diagnostic medical image viewer improves efficiency by allowing providers to stay within a single system, eliminating context switching, logins, and other distractions.
- One radiologist writing a report, one non-radiologist accessing an image or report, or an entire care team viewing an image during a conference: Coordinated, patient-centered care requires teamwork, and teamwork requires communication. The above features allow teams to convene, communicate and share data no matter where they are, what system they’re using or what files they’re viewing.
The coming year will see a transformation in the way providers work alone and with each other. We’re excited to play a critical enabling role in this transformation, by making providers more efficient and effective with mobile solutions.
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