When technology is a barrier to care

Are doctors suffering at the hands of the Herzberg principle--which says that the best way to discourage workers is to subject them to policies and procedures that don't make sense? 

An article in the Atlantic explores how changes in the healthcare payment model, health IT and the doctor-patient relationship are discouraging docs.

"It is easy for many healthcare leaders to forget that doctors go into medicine not because they enjoy entering data into complex electronic health records and ensuring that their employer gets paid for everything they do, but because they want to make good diagnoses, prescribe appropriate treatments and help patients," the article states.

Paul Weygandt, M.D., an orthopedic surgeon, told the Atlantic that contemporary medicine has let too many "intermediaries"--financing, technology and practice structure--get between patients and doctors, and too much time is focused on generating revenue over quality.

Technology is made with engineers in mind, not doctors, Weygandt says. It's often reported that doctors and nurses are left out of the design phase of building new technology.

One example of this is the need to give nurses a seat at the health IT development table, since they actually know what's necessary to achieve optimal patient care. In particular, Elizabeth "Betty" Jordan, R.N., an assistant professor at the University of South Florida College of Nursing, told FierceHealthIT in a recent interview. Nurses are often given demonstrations on IT tools that already exist--including tablets and other monitoring devices--but are not given the opportunity to join in on such conversations during the technology planning and development stages.

This is where doctors' input would come in handy. Of course, new technology can help doctors practice better medicine, but change isn't easy, Weygandt notes.

"Every innovation should be tested not just to see if it increases revenue or cuts costs," he says, "but also to ensure that it enhances the doctor-patient relationship."

In another example of docs' attention being diverted by technology, doctors who use electronic health records in the exam room spend about one-third of their time looking at the screen, which might detract from patient communication, according to research from Northwestern University.

However, in summer 2012, it was reported that eighty percent of physicians in a MedPage Today survey say technology has improved communication with their patients.

To learn more:
- read the article in the Atlantic

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HIT from a nurse's perspective: Put us at the development table

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