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Plainly Speaking: A hitchhiker’s guide to the [Healthcare IT] galaxy

by Ellen Badinelli | December 08, 2017

I am always struck by how industries evolve language for the benefit of, and use by, its members. But membership has its privileges and its drawbacks. While simplifying ways for insiders to communicate, it excludes, or at least distances itself from, those not part of its club.

doctor shrugging, confused

Such is the state of healthcare IT, breeding an entire cottage industry of acronyms worthy of their own syllabus. Health IT is one link in the healthcare supply chain of interoperable links, and its value lies in its ability to push and receive information to and from its fellow linked parties. Perhaps if challenges and achievements in health IT were discussed in plain English, it would be easier for physicians, employers and the consumer public to digest. Our representatives in DC could also better understand how legislation helps or hinders patient care; the repeal of Net Neutrality is a timely example of the health industry failing to persuasively advocate.

Perhaps if challenges and achievements in health IT were discussed in plain English, it would be easier for physicians, employers, [our DC representatives] and the consumer public to digest.

Being somewhat versed in this code, when my physician couldn’t locate my patient record, I asked him when he subscribed to his current vendor. As the lightbulb went off in his head, he quickly navigated to a “separate patient records portal prior to EMR” subscription and found me, explaining the 30-minute delay. Further conversation revealed my practitioner was unfamiliar with much of the acronyms health IT relies on (e.g., HIE for Health Information Exchange,  HISP for Health Information Service Provider), and reported he is frustrated that his EMR vendor can not integrate his practice’s earlier patient records, nor does it provide follow-on training to him and his predominantly new staff. He added that his vendor offers no means of direct communication nor does his Accountable Care Organization have a channel or procedure for him to report deficiencies. Consequently, his pain points remain, as does a lack of guidance to his to his staff on its usage.  I can’t verify the accuracy of his statements, but the fact that he believed them to be true indicates little chance of resolving his needs, his office turnover declining, or preventing more of his patients from needlessly waiting while donned in paper gowns.

Like much of the population, I am cramming in my family members’ visits before year-end to use up my HSA dollars. As a new member of the Chilmark team, I have a few questions, in addition to my usual, of the doctors I visit. So far, the same experience noted above was reported by two other physicians. A couple more on my schedule before the year is out and I may wind up with a straight flush!

The EMR vendor’s relationship is with the larger ACO entity, but patient care is in the individual practices by the professionals administering care, and the few I spoke with reportedly felt their workflow issues remained unaddressed. All were surprised and genuinely appreciative that I sought their opinions and experiences in accessing the data they require. We should be mindful that by creating our vernacular for health IT professionals, we do not omit other stakeholders in the conversation whose participation is required for improved and engaged patient care.

Author’s Caveat: This is just my casual survey from a suburb outside NYC but I am eager for others to conduct and comment on their own.

2 responses to “Plainly Speaking: A hitchhiker’s guide to the [Healthcare IT] galaxy”

  1. sue ann says:

    I find this to be oh so true.
    As an IT savvy administrator (not expert, but no slouch), I spend much of my time translating for my providers and staff. Layer on the IT issues the nature of complicated medical economics, and the situation can rapidly result in the perfect storm – for somebody.
    We navigate this so often for our patients that when they get out of our clinic, they are shocked and frustrated.
    It’s no surprise to me the ACO for your doc is fumbling the ball. After all, the EMR can’t provide support for the doc or the staff unless they know, and nobody at the ACO/practice is telling them. Squeaky wheel gets the grease, and I find that I have the capacity to be damn irritating to get results.
    But healthcare workers are often harmonizers and don’t want to cause trouble. So they fume and complain.

  2. I appreciate your assessment Sue Ann; the ACO’s failure to assign a dedicated interpreter between the EMR vendor and its end users, providers/physicians, risks negatively impacting work flow, alienating staff and as you noted “fum[ing] and complain[ing]”. Your organization benefits from your stated “capacity to be damn irritating”!

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