Takeaways

Technological Innovation Meets Reality 

• Patient volume has increased exponentially since the 80s, making time the most significant commodity for health systems and physicians.
• With narrow margins, health systems cannot sacrifice patient volume and therefore must find ways to operate more efficiently.
• Technology is often developed independently from the clinical user experience, resulting in inefficiencies that defeat the purpose of the technology.
• Electronic medical records (EMRs) can add value to health systems. However, if developed without the patient and clinician experience in mind, EMRs can become too cumbersome for patient and clinician needs.

Tales from the "dark side" 

Examples of what goes wrong when innovators don't understand clinical needs:  

• Carolyn gave the example of EMR prescription entries. With a pen and paper, it would typically take 30 seconds. But with numerous fields and seemingly infinite options, writing scripts has become time-consuming.
• More input options are not necessarily better, as too many choices can become overwhelming. A clinical perspective could help developers prioritize EMR fields.
• The patient's user experience is often missed in technology development because their convenience isn't always factored into development decisions.
• For example, Chris worked with a health system that was implementing a new EMR. The marketing team was brought into the project after the developers had created multiple logins for patients across different units (hospital, urgent care, primary care clinics). Had the patient experience been considered, only one login would be necessary.

Technology done right 

• Before EMRs, patients communicated with providers via fax and received responses through the mail. This process didn't allow clinicians to confirm that patients had received their messages.
• New EMR technology allowed Carolyn to close the communication loop by notifying her when the patient had received her communications.
• Machine learning for prescriptions is another example of a positive technology-to-clinical experience in which the technology made recommendations based on past prescriptions.

Improving the patient experience

• Clinicians know that listening is crucial, but listening becomes challenging with limited time due to significant data entry requirements.
• Facilitating clinician workflows results in more time with patients to listen and understand their problems. More time with the patient leads to better connections, better diagnoses, and more referrals.
• Historically health systems have focused on the "Triple Aim" – population health, patient experience, and resource stewardship. Now, Carolyn believes it should be the "Quadruple Aim," adding clinician experience as a pillar of focus.