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Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

Improving clinical workflow and productivity. Are you focusing on the wrong things?

Improving clinical workflow and productivity. Are you focusing on the wrong things?

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image“Despite the billions of incentive dollars injected into the healthcare system to spur health information technology adoption and boost patient engagement, traditional forms of communication between provider and patient still dominate, according to a new study.” So writes Erin McCann, Associate Editor at Healthcare IT News. Ms. McCann reports on a new study of more than 600 healthcare providers sponsored by TCS Healthcare Technologies, the Case Management Society of America and the American Board of Quality Assurance and Utilization Review Physicians. It shows that the majority of healthcare providers are still using communication tools of the last century—this, during a time in which other industries have rapidly moved on. When communicating with patients, the majority of physicians and other clinicians are still using the telephone (91 percent), face-to-face conversations (71 percent) or “drumroll please”, letters i.e. snail-mail (74 percent) to communicate with patients. 

As a nation, we are investing tens of billions of dollars in health information technology and electronic medical records. Our already cash-strapped hospitals are plunking down hundreds of millions of dollars for new or upgraded information systems. Just as an example, I’ve learned my former 350 bed, not-for-profit community hospital is spending $110 million over seven years to swap out their old hospital information system for a new one. It is the largest capital project they have ever done, more than any new service line or building. But when all of that is said and done, will doctors and nurses still be communicating and collaborating primarily by phone, fax, and snail-mail? Let’s hope not.

Some of the most amazing productivity gains and satisfaction stories that I hear these days from my clinical colleagues have nothing to do with their use of electronic records. Yes, doctors should be using electronic records for all the reasons I have evangelized over the years on this blog. But that is not necessarily where they will see big productivity gains or positive changes in clinical workflow.

imageThe big gains I see come squarely from improving communication and collaboration with tools like messaging, email, voice and video. One small primary care practice told us they are saving 30 days of medical assistant time simply by using the secure instant messaging application in Office 365 to improve the ways staff communicate in their clinic. One of our large tertiary care centers in Australia has enjoyed huge productivity gains after specialists in the hospital stopped traveling far and wide to visit community clinics and started using our Lync unified communications technologies to do their clinical community education and remote consultations.

imageWe are also seeing productivity gains when clinicians select the right devices for use in their clinics or hospitals. Sure, some of those bright and shiny tablets on the market are great consumer devices, but they typically bring with them lots of headaches when you bring them to work. Doctors complain about complicated log-ins and lots of waiting when trying to access hospital or clinic resources. Their IT departments may scold them about security and privacy risks associated with these consumer devices that cannot be managed in the enterprise. But when doctors start using a new generation of devices like our Surface Pro tablets or other tablets running Windows 8 or 8.1, suddenly the conversation changes. Docs have told me that using the right device can mean seeing a couple more patients a day or going home at the end of the day without bringing their work home with them.

So, take a closer look at your clinical workflow with an emphasis on the kinds of devices you are using and the ways in which you are communicating with your patients and collaborating with your fellow clinicians. Maybe you’ve been so focused on the EMR that you are missing some of the really big opportunities to improve the quality of the care you deliver and the satisfaction of your staff, colleagues, and patients.

Bill Crounse, MD    Senior Director, Worldwide Health         Microsoft

  • This was a very compelling article, and makes me wonder where I can utilize some of these tools.  Our clinical already uses instant messaging.  An area of weakness is contacting patients to remind them of appointments and or to inform me them of necessary testing.  Often we have the wrong telephone numbers, even after asking them to confirm the information at registration.  Another barrier is our clinics do not have the capability to text the patients.  It seems like just about everyone has a cell phone with texting capability even if they do not own a computer.  

  • Thanks for the great summary about how communication is severely broken in the US.  I wanted to share with you our startup that is focused on fixing that gap between providers.

    Wanted to get your thoughts - www.referralMD.co  

    Would like to chat with you soon, thanks.

    jonathan (at) referralMD.co

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