EMR; Now or never?

by Dr Jason Tee

Have you ever wondered why healthcare takes a longer time and seems to be stuck for decades behind other industries when it comes to adopting new technologies? In Malaysia, only a small percentage of hospitals are equipped with an EMR (Electronic Medical Record). Also, clinicians are not embracing the technology as they find it overwhelming or troublesome to use it.

Despite great enthusiasm, Hospitals have been notoriously slow to adopt digital innovations. According to Harvard Business Review, much of the blame can be attributed to hospitals’ misaligned budgeting and incentive systems. Many assume that the capital investment made into a technology project simply represents a regulatory or a trend requirement practices must fulfill. Too often, a new implementation of technology such as the EMR is classified as an IT project. Hospitals roll out EMRs thinking that it is just another diagnostic equipment or a smart-phone that is ready to use as soon as your turn it on. Unfortunately, that is not the case. The implementation cannot be solely led and championed by IT.

There will be clinicians who are not aware of ongoing implementation or have never even seen or heard about the existence of the EMR before. Moreover, clinicians are given insufficient training and onboarding support to use the system effectively. Every clinician is unique with their own specialty and they all function differently from one another. A single workflow or configuration will not address every clinician needs and experience. Most hospitals underestimated the extent of the changes that are coming and they face rejections from clinicians. Unfortunately, patients fall victim to all the above.

Ideally, the clinician experience comes first. Clinical leaders from physicians, surgeon, nurses, ancillary departments and business operations should be fully invested and accountable for the success of any EMR implementation. Clinicians must be given the responsibility for planning the implementation because they know which tasks are important for them without compromising on patient care and safety. They must be given the mandate to incorporate their daily workflow into the EMR which in turn will help improve their engagement and experience with the technology.

A successful implementation is less about technology. It is about having an effective governance and change management in place to transforming workflows and processes to be more efficient, patient-centered and information-driven. EMR must not be a tool to record progress notes nor a tool to burden the existing workload among the clinicians. It should be a member among the care team to improve efficiency, safety and effectiveness to provide the best of care to patients. Clinicians are trained analysts to recognize patterns. They are trained to recognize historical signs, symptoms and trends in diagnostical results to formulating rational patterns leading their thought to a final diagnosis. The EMR should replace tedious paperwork and administrative tasks away from the clinicians. Clinicians will then be able to spend more face time with the patients and prioritize their knowledge and skills into critical thinking to provide the best care to patients.

Finally, as we strive to deliver a more personalized experience in health care, the patient-clinician relationship will always remain the centerpiece of providing high quality care.

You’ve got to start with the customer experience and work backwards to the technology.” It has been two decades since the late Steve Jobs expressed his thoughts and it has become the key ingredient to creating a sustainable product or services in any industry today.

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