It's Time to Practise Better Medicine

This article from @KathyKrostof on CBS got me thinking this week. Although as physicians we're no strangers to the art of complaining, it does appear that things are really getting strained out there on the front line. Talking to friends and colleagues from many different disciplines much of the frustration seems to stem from not being able to practise the sort of medicine we want to, and indeed signed up for when we first entered medical school. Too little time with our patients, over burdensome paperwork, a disjointed system where half the time we are in the dark as to what's happening with our patients outside of the office. I know I have to frequently spend significant amounts of time trying to piece together what's been happening with patients who see other specialists in different institutions; usually by wading through a disorderly pile of faxes or letters. This isn't medicine as it should be, this is fire fighting and disaster aversion. I am constantly amazed at how backward we have been, and to some extent continue to be, in how we practice medicine and deliver care.

This blog posting by @GertiTechBlog speaks volumes about the challenges faced by many of us, especially those working in primary care. And it is my feeling that the reason many physicians are feeling unhappy at the moment is not because they've fallen out of love with the practise of medicine, rather it is increasingly frustrating trying to do a good job.

Technology has transformed many aspects of our lives. It is sometimes hard to remember that we used to have to go to a travel agency to book a flight or a vacation, or go to a book store to buy something to read. Many of us now have complete control of our finances and bank accounts via the Internet and hardly ever have to visit a branch. Yet the practice of medicine has hardly changed during the time that this revolution has occurred in other areas of our lives. Why is this?

Part of the problem is undoubtedly the fact that as providers of care we have been extremely reticent to adopt new ways of doing things, preferring the status quo of the way its always been done. It wasn't a desire to practise better medicine that drove the uptake of electronic health records, it was the huge amounts of Federal incentives that made it happen. It really is very curious that it should take what is ostensibly a "bribe" from the government to do something positive, rather than taking it upon ourselves to enhance how we practise. Of course there is the debate that EHRs have not actually made the practise of medicine more efficient, cost effective or better...but that's a topic for another discussion!

Perhaps if we spent a little time looking at how other industries have developed and utilized technology over the past decade we could get some ideas on how we could improve what we do. I really do believe that the intelligent use of technology in our day-to-day interactions with patients and colleagues has the potential to improve how we feel about our jobs and also enhance our patients' satisfaction with the care we provide.

It's no secret that most major vendors of products and services have highly sophisticated customer retention and loyalty programs. They want to stay close to their customers, recommend other services that may interest them and find out what they think about what they've received to date. Now this is not a direct analogy with delivering medical care, but there are probably some aspects that still hold true. How difficult would it be for us to inquire from our patients how they are doing, what they thought of their last healthcare interaction and whether they were on track to reach the goals agreed on their last visit? Using traditional face-to-face interaction would probably prove quite difficult (or at least time consuming) for this, however, this is where technology can help and it is where the likes of Amazon, Expedia and Hilton, to name but a few, have excelled in driving loyalty and trust.

We need to think differently about how we deliver healthcare in the second decade of the twenty-first century. Storing information in an EHR is just the beginning, there are so many other ways we can interact and influence our patients in a positive fashion. Those of us who grasp this challenge, I believe, will drive better outcomes and greater value; two facets that are going to be integral to the future of healthcare.

nGage Health's patient timeline where all interactions with the healthcare system are graphically displayed for ease of review by both patient and provider.