Is there an EHR in the house?

By Wm. T. Oravecz, WTO-Associates LLC

And the clinician said, “I want my EHR now!”
And the patient replied, “Where’s my PHR!”
And they started to see the light.

In the past week, I spent 3 solid days at the side of my mother-in-law who had experienced a rare episode of atrial fibrillation, possibly precipitated by the infusion of gamma globulin she had over the course of the prior weekend. I was there to help serve as her hospital advocate, given the complexity of the environment she was in and her advancing age and ailments. Given my eye, I observed the patient care interaction with curiosity and listened intently and didn’t let an action, measure or question pass un-discussed to ensure Mom knew clearly what the various procedures and results were and what next steps were indicated.

We were at a major city hospital in our state that for a number of years, has embraced the EHR adoption initiative. However, it was clear the routine use of their EHR systems was still a work in progress. What struck me most, while I had this vantage point, was why there is a seeming lack of urgency among clinicians and patients alike on leveraging the useful application of health IT solutions in our near technology-saturated environment.

I saw an attending physician struggle and flip through a patient’s 2 inch binder of medical history; only to close it in frustration knowing there was no way he was going to extract meaningful understanding or background of the patient’s condition. Hence, choosing to simply focus on the information he could glean from the patient during the immediate clinical encounter. Why would this physician and others not say, “I can’t do my practice and patient’s justice without an easily reviewable medical history that a computer should be able to provide? These paper binders are wasting our valuable time!”

I listened as my mother-in-law, rolling her eyes, had to recite what medications she was on and what allergies she had to any medications to the next nurse, nurses-aid, hospitalist, internist and attending physician. Then the question would come again upon shift change with a new set of clinicians. And if that was not enough, having to re-tell the story of what brought her there and what was bothering her. I helped her in this constant communication by offering and flipping through our own paper personal health record.

So, patients and clinicians, the frontline of the health care process, how bad does the process have to get before you start to demand and seek out technology that will simplify and ensure accuracy and consistency in the patient-clinician interaction?

Wm. T. Oravecz is Managing Partner of WTO Associates LLC. and Chief Analyst for HITECH Answers. Mr. Oravecz has 26 years of experience, holding various senior management positions with major IT solutions and healthcare technology firms. He holds a MBA from University of Connecticut and a SM in Radiology from the Pritzker School of Medicine at the University of Chicago.  Contact him at: