On any given day when I wake up, I turn to my phone and plan for the day. I scroll through my emails, check my calendar, check traffic (in a pre-COVID world), and look at my electronic to-do list. Within minutes and three to four clicks, I have access to the data that I need to make informed decisions about my day. Now, I can focus on executing my plan.
As a CEO, the ability to quickly plan my day is important to my business’ success. As a practicing hospitalist, having quick access to up-to-date patient data can be a life-or-death scenario. However, finding the data I need, when I need it, in healthcare takes 10x as long and an inordinate number of clicks.
I have often wondered why technology has been so well integrated into my daily life, while as a clinician, technology is often a roadblock to being highly effective.
I quickly realized the difference between my daily tech and health tech: the applications that I use in my daily life are built for me, the end-user. The technology that I use as a physician—the EHR—was built to satisfy the business of healthcare. Not the delivery of care.
I’m not saying that the shortcomings of technology in healthcare are easy to fix, because they’re not. But it’s time to do the hard things, to reimagine and redesign tools for clinicians, because investing in better technology is a key component in tackling healthcare’s greatest challenges.
EHRs are not a clinical tool
EHRs were developed with the right intent: to give providers access to critical data and the ability to create & easily read documentation, while giving administration the ability to more accurately bill for services by capturing diagnosis in a digital format.
In practice however, EHRs were bulit in the reverse order: billing first, then access to data & documentation. As such, a big piece of the puzzle is missing: workflow. EHRs have done little to improve how we work, not just as individual clinicians, but as teams. Instead of streamlining workflow, EHRs have contributed to communication failures and preventable errors. Critical patient data is often buried by a deluge of information in the EHR, delaying diagnoses and clinical decision making. Due to the lack of effective mobile access for existing EHRs, many clinicians are forced to print their patient lists, scribble paper notes as they do their rounds, and spend additional time transcribing new information back into the EHR…again! In fact, EHRs have led to an increase in printing at hospitals by 11% as shown in a study done by UK based IT firm Logicalis.
Not only is this reliance on paper notes incredibly inefficient, it creates the potential for preventable errors. Paper is inherently NOT a collaborative tool. Paper notes are trapped in white coat pockets where only one person can see them. Instead of facilitating care, this creates new gaps in communication that can inhibit timely decision making. Additionally, printouts are easily lost, become quickly outdated, and contribute to cognitive overload. Frustrated physicians are forced to spend less time with patients and more on administrative tasks associated with the EHRs. This is not just a clinician problem, as more evidence supports the fact that rising burnout rates, in turn, hurt the bottom line for health systems and most importantly, patient care.
The lack of agility and usability of existing EHRs has only been exacerbated by the COVID-19 pandemic. Rising to the call of duty, clinicians are risking their safety and that of their families under circumstances with many unknowns. Yet it is taking a toll. Increasing levels of burnout compounded by the grief and loss left in the wake of the pandemic, is pushing many people to thor limits. Information and protocols are rapidly changing and adapting, yet technology is stuck in the same place, creating more manual work for clinicians and increasing the cognitive load on those who are already risking their safety.
“The next big thing is the one that makes the last big thing usable”
-Blake Ross, Founder of Mozilla
Optimizing the EHR for clinicians & health systems
Clinicians, patients, and health systems need a better solution that allows users to focus less on administrative tasks and more on delivering care. Making the EHR easier to use will ultimately enable safer patient care and happier clinicians.
That’s why we built CareAlign— to make the EHR easier to use, and give clinicians tools that actually support safe, effective, team based clinical care. We believe technology should make it easier to do the right thing for patients, not harder. After witnessing how CareAlign, previously known as Carelign at Penn Medicine, led clinicians to embrace technology while enabling safer care, I knew it was time to bring CareAlign to the wider market.
With every challenge we face in healthtech, I always come back to one truth: technology should enhance, instead of detract from, our lives. It should delight its users, not frustrate them. With user centered design and agile methodology, we designed CareAlign to do exactly that: prioritize agility and end-user happiness. During the pandemic, I am proud to say that within days, we created “bundles” within CareAlign to quickly bring newly developed, locally standardized COVID-19 protocols and workflows to the point of care. We developed COVID-19 specific lab filters, flags, and lists that allowed clinicians to quickly access information on their patients suspected to have or with COVID-19. As face-to-face interactions with infected patients were limited, clinicians found themselves constantly hunting for the hospital room phone numbers to call their patients. Again, CareAlign rose to the occasion by adding tap-to-call phone numbers to the application to improve the clinician-patient interaction. Even still, as we strive to maintain safe distances in the hospital, and in many instances need to handoff to each other remotely, CareAlign supports this seamlessly – something that can not be done adequately with paper. These features streamline how clinicians share information and care for patients as the pandemic unfolds.
When I switch from my physician hat to my CEO hat, I’m happy to see how our platform is able to improve billing for hospital systems – making CareAlign a win-win for clinicians and hospital administration (a goal EHRs have yet to meet).
We have proven that CareAlign can improve a hospital’s bottom line by better capturing diagnoses that would otherwise be lost on paper, and increasing an interdisciplinary approach to care. Further, CareAlign’s mobile interface is designed to eliminate the need to print paper lists, significantly reducing not only the cost of paper, but also toner, shredding and printer maintenance.
The thing I am most proud of however, is hearing users say that CareAlign has prevented errors in their practice, improved the quality of their work life, and saves them time…each and every day.
The problems we are solving are important to me because I have lived through them. And I continue to live through them. They are important to the entire CareAlign team because we know that supporting clinicians can improve healthcare for everyone…which includes all of our families and loved ones. They deserve the best care we can provide.