Tuesday, February 25, 2014

The Art of Medicine CIO Breakfast - What Needs to Change to Get Doctors Back to the Patient?

Medicine is part science.... Part art.

The relationship between physicians and patients is at the core of healing. This begins with hearing and understanding. We want to reimagine healthcare—where physicians can get back to the art of medicine and were delighted to be joined by panelists:

Dr. Mark Kelemen, Senior Vice President, CMIO, University of Maryland Medical System
Dr. Charles H. Bell, Vice President, Advanced Clinical Applications, Hospital Corporation of America (HCA)
Stuart James, CIO, Sutter Health
Dr. Andrew Watson, CMIO, University of Pittsburgh Medical Center (UPMC) (@arwmd)


The panel was moderated by our very own
Dr. Paul Weygandt, Vice President, Physician Services, Nuance
Keith Belton, Senior Director, Clinical Documentation Solutions Marketing, Nuance

and attended by some 50 attendees with varying backgrounds and perspectives

The underlying question:

How do return the focus to the patient. How can physicians navigate the changes and challenges of today’s complex healthcare environment while doing what matters most to them – listening and caring for patients?

The panel discussion addresses current physician frustrations with technology and what needs to change to keep them focused on patients and not data entry. It was clear that the physician’s voice and medical decision making is what matters most in practicing the art of medicine and how do physicians and patients both benefit?

 We know from surveys that
  • 36% of physicians say that EHRs interfere with face-to-face communication during patient care
  • 80% of physicians say “patient relationships” are the most satisfying part of practicing medicine
  • 28% of an average ER physician’s time is spent directly with patients
  • and from a recent HIMSS session interesting Patients prefer doctors to have an EHR
This is about the changing face of healthcare – it’s not just about technology. It’s about how we envision healthcare. How do we explain to providers that this isn’t about technology – this is about a new world order coming to healthcare
Posting every patients Magnesium level multiple times in a note is not good clinical care #artofmedicine #himss14
One of our panelists asked the audience:

How many Docs would go to facility with no #EMR and used paper - no hands went up
We do see value in Health Information Technology

One of the overriding concerns was the need for cultural change. The office or hospital based physician system is struggling to meet the patient needs today. They want to have the right nurse or physician there for them at the right time and indeed at the right place with telemedicine. It’s about cloud-based/consumer-based healthcare.

More consumer-friendly healthcare

We need to get back to that local physician practice – with technology in the middle as a supporting actor but not the main event

Technology cannot be an impediment to taking care of patients

Many physicians are in this field because we are trying to drive change but are struggling with the existing system that fail them. When I see a patient I have to review 10 systems, carry out at least 4 major systems examinations before I can submit a claim that properly reflects the care I delivered:
 I am not taking care of the patient I am taking care of a computer

Dr Andrew Watson told the story of a patient under his care with a terrible antibiotic resistant infection that a patient developed in hospital and he was now under constant supervision adn intensive therapy. But as he said - he never needed to come into hospital - he could have been treated at home. Poignant reminder that Telemedicine is not just about reducing cost - it can be better for the patient and offer better results.

Dr Bell is waiting for the MIDI (musical instrument digital interface) moment so that he can plug into the medical record and go.
As a musician he remembers the implementation of the MIDI interface in the early 1980’s that allowed music manufacturers to create one standard that was royalty free and widely adopted for the benefit of the user musicians and the vendors. He wants that in healthcare - so do I.
Until we change the mandate on clinicians to document 8 of 10 systems to be fairly compensated for the care given  
And importantly the concept of Bring Your Own Device (BYOD) is bringing functional tools into the healthcare setting and will/is revolutionize the care being delivered. As one panelist put it:

my iPad never complains, is always there, has the latest information and access to latest medical updates

To summarize:


  • We need strategies for bringing the focus back to the physician-patient interaction and removing impediments to that relationship
  • Healthcare organizations should be and are encouraging/valuing physician professionalism
  • This is about the changing face of healthcare – it’s not about technology. It’s about how we envision healthcare. How do we explain to providers that this isn’t about technology – this is about a new world order coming to healthcare


Come join the conversation at The Art of Medicine or come to the panel session Thursday, March 27, 2014, 9:00 - 11:00 am EST at the W Hotel,100 Stuart Street, Boston, 02116