Tuesday, November 24, 2009
A Visicalc moment
If you were an early Apple II or IBM PC user, you may remember the first time you saw Visicalc (1979), SuperCalc (1980), MultiPlan (1982), or Lotus 1-2-3 (1983).
The spreadsheet solves a real problem - it saves time, it empowers its users, and people are more productive using it.. No more paper, pencil and calculators. No more days wasted manually computing "what if" scenarios.
I call this joy from the early days of personal computing a "Visicalc moment".
One challenge we face as we roll out electronic health records to every clinician is that the first time they see an EHR (of any type, from any vendor), they rarely have a "Visicalc moment".
Because we have not marketed the benefits of EHRs to clinicians, they are not sure an EHR saves time, streamlines their workflow, or brings them a better quality of worklife.
There are 3 ways to motivate most clinicians
1. Pay them more
2. Offer them more free time
3. Apply Peer Pressure
How can we leverage these principles clinicians so they will have Visicalc moments?
A few thoughts
1. Electronic medication workflow in an EHR saves time, reduces the number of calls/pages due to unreadable prescription and streamlines the refile process.
2. Templates, Macros and voice recognition can speed up clinical documentation. Of course, they must be used wisely to avoid creating inaccuracies that are persisted forever in the record. Electronic clinical documentation can be electronically exchanged between referring clinicians and specialists, leading to a peer preference for those who document electronically.
3. Patient Education can be automated by linking problem lists and prescriptions to resources such as UptoDate, Healthwise, and Preop.com
4. Decision Support such as automated ordering ensures the safest, most effective therapies are given based on evidence and patient specific data. It can also be used to generate alerts and reminders in support of pay for performance programs.
5. Administrative simplification streamlines the revenue cycle, reducing denials and AR days.
Thus, EHRs, especially those offered via the web in software as a service models can generate income, save time, and keep peers happy.
Let's hope the regional healthcare IT Extension Centers and hospitals which rollout EHRs for their community physicians can achieve a few "Visicalc moments".
Posted by John Halamka at 3:00 AM