Incorporating EHRs offers the promise of better data. With that data, our possibilities are endless. We can spot patterns for an individual, diagnosing and treating conditions sooner, and we can trend population health to help hospitals meet the changing healthcare needs of their area. That is our goal, but we are drastically missing the mark.
Coming to the end of Meaningful Use II, we have the systems now, but our data is lacking. In a recent report, McInsey & Company released findings that 80% of our EHRs held unstructured data – i.e., data that is unusable for true population health management and MACRA reporting. Why is this?
Although you can hire a team to clean up your data after the fact, it’s a never ending battle. To really solve this problem, we need to start at the beginning: with Data Capture before and during the patient encounter.
In software development, there is a term called friction. Friction is the amount of difficulty a user experiences when trying to complete their task with the software. The more a user feels friction, the less likely they are to use the system. And if they must use the system, like in healthcare, the more likely they are to create workarounds and shortcuts to avoid feeling frustrated.
We are currently failing at Capture during the inital patient encounter because our systems are too labor-intensive. There is too much friction. Doctor’s and nurses have other priorities than to wrestle with their EHR, searching through drop downs with thousands of options, and doing this hundreds of times a day. It is a poor use of their time. The doctors and nurses know this too, so they take shortcuts. Documents are scanned and attached to records to check off the “digital” requirement, but the information is not extractable and hence, not usable.
The truth is, we have forgotten that we put very expensive systems in place to have better data. Because meaningful use is a requirement, we set about meeting the requirement while ignoring the goal. This begs the question, is our software itself to blame for our data Capture issues? The answer is yes and no.
Software is deterministic. This means that it can only do what it was programmed to do. No more, no less. Because each organization is different and has a slightly different flavor of needs, software is typically written to be configurable. If you turn this switch one way, it will do this. If you turn the switch the other way, and it will do that.
Where we are missing the mark is that our EHR systems are not configured in a way that aligns them with the unique Capture process of each organization. Every organization is different. The people, processes, and services vary to a significant extent and out of the box, no EHR will “just work.”
Our EHR systems are completely capable of meeting our needs, but there is a lot to configuration to get it right. Our world of healthcare is complex, so the breadth of configuration reflects this.
If we are truly serious about the goal of better data, then we need to get serious about fixing our data Capture process beginning with patient input and the patient encounter. And to get serious about data Capture, we have to first understand how to configure our EHRs so they are more tailored to our needs and make this activity a priority. Processes have improved. New technologies exist and proper data capture setup can solve most of our EHR headaches we experience today.