An open letter to Clinicians: It’s Time to Demand Better.

by | Aug 14, 2018 | Blog

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Fellow Clinicians –

When we go to work, we are stepping in to one of the most personal and high stakes jobs. Every day, we ask patients to put their total faith and trust in our experience as we navigate them through some of the toughest and scariest times of their lives.

It’s not an easy calling, but it’s one we all do with pride.

With every new patient we are given pieces of a puzzle. Some puzzles we can solve quickly, thanks to our years of training. Some puzzles are more complex, with multiple patterns and missing pieces.

For those most complicated puzzles, we rely on tools and our colleagues’ knowledge to help us. However, the tools we are using, often digital based, seem to hinder our workflows and weaken our ability to collaborate. These tools, built without an end-user focus, just aren’t cutting it. They lack seamless communication, mobility, and easy collaboration. Instead of being built with our workflows in mind, we are continuously asked to adjust our workflow to the technology, or to do more training to “learn how to use it as intended.”

Unfortunately, I think the tail is wagging the dog. Instead of us bending over backwards to fit to technology, shouldn’t technology be built to make things better for us? To save us time? To help us provide better, safer care?

In our private lives, we interact with well designed technology every day that truly delights its users, and not only fits to workflow, but improves it. Why then, is health IT any different? Why are we lacking tools that seamlessly integrate into our clinical workflow? Perhaps because we, the front-line clinicians, are not the “customer” … or at least not the ones that matter to vendors. Therefore our voices are not heard.

It’s time to speak up. To speak louder, so we are heard.

I’ve trained hundreds of new medical students and residents on how to use EHRs and other Health IT tools. Almost uniformly, they enter the field bright eyed and motivated, believing they can make a difference in improving our systems. This is no surprise since they have grown up with technology and see how it can truly make workflows better. However, with every idea that is ignored and every inefficiency they are asked to accept, their optimism is quickly replaced by helplessness and apathy. They adopt an attitude of “this is just how things are and I’m never going to be able to change it.” I think they deserve better. We deserve better. Our patients deserve better.

We need to demand better.

An important consequence to the lack of usability of our current EHRs leads to an over-reliance on paper for our clinical workflow. From to-do lists, printed vitals and labs, to scanned PDFs from consultants and other clinical practices, we are practicing with tools that are archaic by today’s standards. What other profession is so dependent on fax machines? With the current lack of interoperability, we spend more time on hunting and gathering clinical data, and then hoarding it in paper stacks and lists. It is no surprise then that pieces of the puzzle are getting lost, our patients aren’t getting the best care possible, and good colleagues are burning out.

The digital revolution in Healthcare is a necessary first step. EHRs have offered databases for information that was previously filed away in a basement. They are a great foundation to move our industry forward — but they must evolve. We must take them to the next level of functionality and usability.

Better communication & collaboration. Better user experiences. Better tools.

Technology should delight its users, rather than leave them frustrated and exhausted. Our tools should help us solve our most complicated puzzles, not leave us more confused. It is time we raise the bar and demand more from our digital health tools.


Subha Airan-Javia, MD

Chief Medical Officer, TrekIT Health