Bridging Business & Healthcare : Healthcare Management Consultants for Dispute Resolution, Valuation & Clinical Compliance

As all of us who work in healthcare know, we are all swinging for the fences to hit the home run of Electronic Health Record ("EHR") implementation. Practices and hospitals across the country are racing to make sure all of the myriad of boxes are checked, T’s are crossed, and I’s are dotted to be sure that their version of the EHR meets all of the new standards for meaningfulness. There are core measure items and menu measure items – pick all from column A and some from column B and you now have meaning. The search for meaning has been defined, but achieving it still seems a very distant reality for many of us that are just stepping up to the proverbial plate.

In the midst of this mad scramble toward meaning, two very different studies on IT were released this week. On Monday, a study was published stating that only “fully functional” emergency department EHR’s led to lower lengths of stay and lower waiting times. The study goes on to say that only 1.7% of the systems surveyed met the definition of “fully functional”. In fact, if you ended up in an ER with an EHR that was of the more basic variety, your wait time was likely to be longer than the majority of hospitals with no EHR at all. (A swing….and a miss.)

On Thursday an article in the Boston Globe's health blog, White Coat Notes, highlighted a new study being undertaken by the Emergency Department ("ED") in Boston’s MetroWest Medical Center. The program allows patients to text the ED to check on wait times. One of the goals of this program is to “promote better customer service” by decreasing waiting times. At the time of publication of the article, over 450 patients had sent text messages to the two emergency departments in the MetroWest system. The average wait time was 24 minutes to see a physician. (A bunt down the third base line…and he scores!)

Like many other parts of the new healthcare reform world, many of the goals may be admirable, but seem unobtainable and overwhelming to many hospitals and healthcare providers. Successful implementation of the EHR across the healthcare system may be the home run we are all looking for, but if we want to achieve true meaning for IT in healthcare, we may have to hit a few singles first.

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Recently, a friend of mine went out to his car late one night to run an errand, only to find that it would not start. He was immediately concerned as he had an early AM meeting that he couldn’t miss. He had just replaced the battery so knew it must be something else. Knowing nothing of cars, he did what any of us would do, he Googled it. One brief phrase – “Infiniti QX56 won’t start battery new”—and presto, up popped three online mechanics, one at $15, one at $25, and one at $45. Choosing the middle of the range, he clicked on the link and there was his trusty online mechanic at 11:30 PM to answer his questions and hopefully solve his dilemma. After a brief history of the problem, the mechanic quickly shared with him what he thought to be the most likely answer – it was a relay switch. Fortunate for him, this particular model has 6 other relays that are identical, one of which was to the fog lights. The fix was simple; he would just need to switch out the two parts. Knowing that my friend was not adept in the ways of car repair, the mechanic, e-mailed him a diagram of where to find the correct part, he switched it out, and like magic, his car started up. Thirty minutes after getting online – Problem solved.

As I thought about this story, it made me wonder about how we continue to care for patients today. My physician’s office is one of the very few places in my life that I have to wait for an appointment in order to receive the information I want or need. A friend of mine called last week for an appointment as a new patient with a specialist she needed to see. First available appointment – 6 weeks.

Much of the discussion we are seeing is about how physicians must change the way we practice in response to healthcare reform and the new law. Although that is undeniably true, there are other forces of change at work in the world of healthcare. Given that nearly everything else in our lives has become designed around immediate access, it is only a matter of time until physician practices must find a way to get on board. 

• New models of care, using social media tools and immediate access such as hellohealth are emerging. Follow @jayparkinson on twitter to see more.

• Jennifer Shyne Dyer, MD, [@endogoddess] is using texts and tweets to monitor her diabetic patients. 

• The Mayo Clinic recently launched its new Center for Social Media with the tagline Bringing the Social Media Revolution to Healthcare.  

If physicians are to survive and thrive in this new healthcare world, they will need to join in this “revolution,” developing new and creative ways to care for their patients and make information immediately available to them.  How long will it be till your patients are really able to see you…now?

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