Tag: ADOPTION

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Future Doctors

Worldwide, almost everywhere, increased internet access and the growing use of digital devices have fundamentally altered the information available to patients. Patients are becoming more empowered by technology to make healthcare decisions; patients now commonly ask for more information and expect to be involved when making diagnostic and therapeutic choices.

At the same time, the healthcare system is becoming increasingly complex; every country is trying to figure out how to end the pandemic socially and medically.

As a result, many doctors feel unhappy, disempowered, and alienated from their work systems; they are seen as part of the problem rather than the solution.

The solution is undoubtedly directing us back to technology. The future of healthcare is data and work-smart people. Future doctors will probably need these characteristics enhanced:

  1. Healing ability: having knowledge and technical skills to heal people beyond treating disease. Healing and treating are related concepts, Healing, however, can come in many forms other than treating.
  2. Understanding of systems: doctors are no more the dominator but essential players in healthcare systems, from clinical teams to national and international systems. Doctors need to understand those complex systems and, more importantly, know how to improve them.
  3. Enthusiasm for learning and changing: medical students are taught that medical practice is a lifelong learning process. Nowadays, continuing learning is an essential survival skill; love to learn and change is a characteristic of future doctors.
  4. Comfort with technology: it is particularly true with information and digital technology; recognize that doctor plus technology will be much more effective than a doctor alone.
  5. Patient-centered: the concept of patient-centered care emerged in the early 50s; it exploded exponentially in the late 90s. As we strive to improve the quality of care, a patient-centered model can play a pivotal role in this process. More research is needed to explore the various attributes of patient-centered care, its acceptability, digital transformation, and comparative effectiveness in the healthcare arena.
  6. Understanding of evidence: doctors are educated about hierarchies of evidence. Future doctors must be capable of combining different types of shreds of evidence, analyzing and weighting them effectively. Learn to work with and apply algorithms.
  7. Profound ethical understanding: future doctors must recognize the moral issue and have the capacity to think and practice ethically.
  8. Communication skills: listening more than telling. Since Hippocrates’ time, medical school professors have taught their students to listen to their patients. Medical doctors all realize that the patient’s medical history and the patient’s account of his or her illness is the best source of information to make an accurate diagnosis and healing plan.
  9. Love of diversity: enjoying working with people from different backgrounds and of different views and skills.

Social, technological, and science is reforming the role of doctors rapidly. The change of the doctors is driven by patients, knowledge, the workforce, and technological change around us. The SARS-CoV-2 pandemic has thrust many changes upon the doctors in the new ways of thinking and working.

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Rapid Change and Fast Implementation of EHR/EMR

The world is changing very fast. Big will not beat small anymore. It will be the fast beating the slow. – Rupert Murdoch

During the pandemic, many hospitals have shared their experiences of rapidly improving the existing EHR/EMR systems. Some reported their success stories about fast virtual implementation and go-live. Covid-19 requires rethinking and refocusing on priorities. The decision-making process has been shortened, and the actions have moved faster.

1.    WHY need EHR/EMR?

 COVID-19 pandemic exposes both strengths and flaws of EHR/EMR systems. However, despite the frustration and disappointment from the front-line clinicians, we must first acknowledge that EHR/EMR architecture and platform have enormous value in controlling the pandemic and other widespread public health emergencies.

Paperless EHR/EMR system is essential and assured for early detection of the risks, report of abnormal conditions, rapid diagnosis, and the appropriate treatment and life support. 

Eliminating all the paper and minimizing direct contact is a must in the whole of the caring process.  The workflows need to be connected seamlessly and communicate effectively, such as identifying patients, booking appointments, admitting to ward, referring consultation, coordinating MDT review, electronic print, bed-side care, and post-discharge follow-up, etc. Also, the recommended Covid-19 protocols evolve very quickly, and EHR / EMR enables hospitals to implement changes far more uniformly.

2.    What EHR/EMR systems are the choice?

There is a varied range of EHR/EMR products locally and internationally. Robustness, interoperability, organizational feasibility is of choice. The advantages and power of such choice have been proven during the pandemic, ensuring patient care safety and quickly protecting clinical staff at the same time. The capability of information sharing allows hospitals to track and report abnormal conditions faster and accurately.

3.    How to rapidly improve and how to fast implement?

Most hospitals already have workable systems of daily huddles in place. A fast virtual implementation during the Covid-19  strengthens a lean approach, i.e., rational use of resources without waste, implementing the necessary changes.

Hospitals are more likely to make fast decisions, consider much less about those concerns that may delay the change progress. For example, before Covid-19, the staff often spend time in scoping requirements and developing and testing solutions before rolling out changes. This process has been modified to implement changes quickly. New EHR/EMR features are constructed to enable quick back-end editing as processes and guidance change frequently.

During the pandemic, social distancing pushed the implementation teamwork online, which makes communication, testing, and system configuration much harder, and almost impossible to maintain the same level of support and security as onsite. However, those success stories show that new needs invariably create and drive new methods. As Amelia Earhart said, the most difficult thing is the decision to act; the rest is merely tenacity.

The Covid-19 pandemic has forced numerous changes in daily clinical practice. Rapid responses in EHR/EMR help beat the virus and defend the patients. Stay lean to go fast.

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Doctors Must Help Transforming EMR

Doctors and patients often complain about EMRs, often for the same reasons. Both say that doctors spend so much time on the computer, i.e., the number of clicks, taps, scroll up and down required to execute a routine task, or to find a result or report, doctors spend less time focusing on patient’s real needs of care.

Many doctors assume that an EMR system should simply mimic their simple paper processes; this concept has caused many of the problems associated with EMR today. The doctor needs to understand that EMR capabilities are far more beyond paper; it stands to reason there would be differences and complexity.

However, there are ways to integrate EMRs well into the clinical visit, to improve the doctor-patient relationship:

  • Preview the patient’s history and current presentation in EMR: getting familiar with the pertinent chief complaint and other clinical information before greeting the patient
  • Value the first minute by talking to the patient, not using or being busy with any technology
  • Explain what you’re doing: be open about everything you’re doing with the EMR in the patient’s presence.
  • Value the EMR: talk about the benefits of the EMR, use it as a useful tool for engaging patients; for example, let the patient look at the screening while you enter data, read and interpret lab results, and specialists’ reports. Always encourage the patient to ask questions and confirm the accuracy of information.
  • Be positive: if you display negative emotion, it influences the patient, leaves a wrong impression of the visit. The patient will never complain about a lousy EMR but will remember the unpleasant clinical experience and a frustrated doctor.
  • Keep eye contact: maintain it as much as possible throughout the visit. When a patient starts discussing a sensitive or emotional topic, always turn away from the screen and look only at the patient.

These practices can build trust with the patient, ensure the accuracy of the information entered into EMR, educate the patient, make the patient feels more participatory in their healthcare.