Support from technology? Frustration and distraction is common for docs

April 13, 2016 / By L. Gordon Moore, MD

Electronic records are a boon in many ways, but failures and frustration in the field are too common.

Jean Antonucci is a family physician in Farmington, Maine – northwest of Augusta.  She cares a lot about quality and has participated in various improvement efforts for 11+ years, all the while hoping that the wider system of payment and measurement would make it easier for her to help her patients get the best possible outcomes. 

She gets that electronic access to information is valuable.  She was an early adopter of electronic medical records and has spent hundreds of her own hours submitting reports to certification entities that might then grant recognition so that she can maybe get some funding to continually improve care delivery.

The point I want to make is that after more than a decade of national attention, immense funding from CMS and constant feedback from clinicians that electronic solutions in the market fall short, Dr. Antonucci is forced to work on problems created by our technical failures rather than feeling supported and encouraged. Here’s what she has to say:

“This week I changed my workflow (again), and finally saw labs coming in electronically!

Trouble is, the labs don’t go into the patients’ charts. Funny, I thought that’s what the interface was for. My vendor says that the EMR does not recognize “glu” or other abbreviations. I have to teach it.

We paid the vendor $7,500. But the end result is that once again, the PCP [primary care physician] figures out the workaround.  I know how to do this work, but isn’t that why we paid the vendor?

The country’s efforts to get primary care to redesign its delivery system lacks an infrastructure that supports us. New payment systems are few and far between and thus far, inadequate. If the country is to move forward to do a better job of meeting patients’ needs, we had best move out of this very dark place, where, as Don Berwick says* there is full employment for vendors, but as PCPs say, those of us out here on the ground are at the end of our rope.” [Jean Antonucci, MD – Farmington ME]

Technology continues to hold the promise of easier and more seamless work with better insights, but we still have a long way to go.  We would all benefit from solutions that address concerns raised by Dr. Antonucci and others.

L. Gordon Moore, MD, is senior medical director for populations and payment solutions at 3M Health Information Systems.

*Keynote address, Donald Berwick, MD- National Forum, Institute for Healthcare Improvement, December 2015