Healthcare professionals are sold on the clinical benefits of health IT tools such as clinical decision support, e-prescribing, telemedicine and electronic health records (EHRs) – when they work well and don’t interfere with the practice of medicine.
EHRs have been around since the 1960s. Generally, their evolution has been slow, with no significant changes in functionality since the early 1980s. With EHR adoption increasing in response to the federal government’s Meaningful Use Initiative, a shift in emphasis from financial tracking toward clinical use and a growing interest in research use, the pace of change will undoubtedly pick up speed in the near future. According to a survey by PricewaterhouseCoopers’ Health Research Institute, a majority of healthcare organizations have clinical informatics programs. This is great news for health IT professionals: almost half of the respondents indicated they employ clinical and non-clinical health IT specialists.
Without concurrent investment in IT infrastructure, however, users of health IT systems may experience frustrations such as long load times. Another significant pain point is the lack of support for mobile devices, which many healthcare professionals have integrated into their practice on a “BYOD” basis. Electronic systems that interrupt provider workflows or require more time and effort than paper are unlikely to be successful. Caregivers resist using systems that interfere with their efforts to provide good, efficient patient care, and rightly so. The solution to all of these issues is to include end users in decisions about systems that change how they work.
The best time to think about the potential impact of health IT on clinical workflows and plan for corresponding infrastructure investments is before implementing new clinical (or research) software. In 2008, the US Agency for Healthcare Research and Quality (AHRQ) developed a publicly available toolkit for health IT implementation that can be used by any organization. The agency is currently seeking approval for an information collection project to evaluate the use of the toolkit in small to medium-sized physician practices, where ineffective health IT implementations may have the greatest impact.