Tools of the trade

by | May 10, 2021 | Blog, EHR

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From the beginning of time, (wo)mankind has developed tools to make us more efficient. While on the face of it, Medicine has been a proud beneficiary of this innovation, the preponderance of medical inventions in recent decades have been focused on molecular discoveries, or devices to support procedural skills. For example:
Scanners of all types: CT, MRI, advanced surgical imaging guidance etc. → Equivalencies: radar, sonar, etc.
Remote monitoring equipment of all sorts → Equivalencies: The internet, wearables, etc.
A myriad of surgical tools ranging from the scalpel to the machines that enable us to operate at the microscopic level → Equivalencies: robotics to everything in the military
And so much more….

What we don’t have, are the process management solutions that almost all other industries use to support collaboration between software developers, business people, analysts and more. Things like Gannt charts and project management tools, even communication tools like Slack are new-on-the-scene in medicine. In fact, as someone who went straight through from school to residency to 10 years as an attending physician – i.e. never exposed to business – I didn’t even know what project management software was.

It is fascinating because on one hand, medicine has moved forward by leaps and bounds. Care is no longer given by one person who is all-knowing. We have armies of specialists who work together and as a team deliver better care than any individual possibly could. But there are vanishingly few tools or systems (apart from CareAlign!) that allow for collaboration to be systematic, well coordinated and dynamic. Instead, collaboration is limited to huddles in hallways or at nursing stations, notes scribbled on paper and passed from one person to another, 1:1 messaging. To illustrate, try this: google “medical intern” and then look at images. Almost all of them – especially those that depict interns at work – show a picture of someone carrying a paper notebook. This system literally hasn’t changed in 200 hundred years! Now google “project manager”, “software manager” or “business analyst” and take a look at those images. The ratios of paper to computers are exactly reversed.

This situation has to change. The IT community in healthcare is pretty convinced that EHRs can solve every problem. The philosophy is “buy an EHR and do everything in the EHR”. But EHRs were not designed to manage tasks or workflows and indeed they don’t offer any solutions in this area. If the lack of offerings isn’t enough, consider that the average number of integrations that SaaS software has (outside medicine) is over 300! (EHRs are SaaS software!). This clearly indicates that in other industries people have realized that one system can’t have all the answers. You want to buy systems that work together to give you a great overall experience. As an industry, the pendulum has swung too far from “best of breed” to “all in one no matter what.”

This limitation is felt even more acutely by cognitive based specialities such as internal medicine and family medicine. There are no machines or devices for us to ask the hospital to get for us to better care for patients. Instead, we rely on our hands to examine, and our collective team’s education and experience to develop the “right” medical plan for our patients. Then what do we do? We carry out that plan – largely through technology. Order this medication, check that lab, consult that other team. However when we ask for tech to better accomplish these tasks and make less errors, we are told to use what we have, even if it is not good enough. “But at the same time, don’t make a mistake because if you do, you can’t blame it on the poorly designed tech. It’s all on you.”

The result? Caregivers are massively overwhelmed and overworked. Teams are not able to effectively work together and important things fall through the cracks. Patients suffer.

We must find ways to do better. Technology should enable givers of care to spend more time caring and less time clicking. We must start to recognize that one system can’t do it all. We need solutions that connect to and leverage our foundational systems (EHRs), while also remaining agile and responsive to clinicians’ needs. CareAlign’s focus on workflow improvement gives clinicians back an hour every day. An hour they can spend talking to a patient, taking a better history, talking to a consultant, coordinating a discharge. Providing better care. If you work as a clinician, whether you use us or another technology, everyone needs software that enables excellent teams to be the best they can be. Together.