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Healthcare is a world full of adages, aphorisms, and narratives. From “first, do no harm” and the “triple aim” to “keeping the patient in the center of care” while snatching that “low-hanging fruit,” providers and regulators seem to love summing up their goals, guidance, and priorities into pithy phrases that can help them communicate their visions. One of those phrases is somewhat less rousing, yet it remains one of the most pertinent and frustrating themes to emerge in recent years: “resistance to change.” Healthcare is notorious for it – curiously so for a profession rooted in discovery, experimentation, and observation. During the earlier part of this fleeting decade, resistance to change reared up in opposition to the electronic health record, which promised to transform the day-to-day workings of every component of the healthcare ecosystem. EHRs certainly delivered on that promise, but not in the way that most providers expected or desired. Early systems were clunky, cumbersome, and prone to from a clinician’s day through poor design, too many alerts, and overwhelming documentation requirements. Many would argue that newer iterations of the EHR haven’t changed significantly enough to restore the joy of medicine to overworked providers, who now have much more data but barely more insight to compound the everyday challenges of patient care.
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Dissatisfaction is still at alarmingly high levels, and “physician burnout” is now just as common to hear as any of healthcare’s other favorite phrases. Providers often spend than they do seeing their patients, and many stay long after the clock strikes quitting time to finish up their daily administrative tasks. The current situation is simply untenable, and more stakeholders are starting to accept that something has to give if healthcare professionals are to have any hope of meeting their responsibilities to patients while remaining financially soluble and continuing to improve the quality of their care. Clinicians will immediately protest that they have been demanding modifications for years now, but their vendors have not responded quickly or comprehensively enough.
Vendors will likely fire back by pointing out that providers are suspicious of new tools and workflows by default, and that creating organizational momentum for innovative strategies is often a difficult task. For providers and health IT developers locked into the same old patterns of friction and fractiousness, it may seem like the intolerable status quo won’t be changing any time soon. Not even value-based reimbursements are significantly shaking up the technology equation at the moment. Instead, the pressures of population health management and care coordination are generally just adding new tasks on top of the same health IT foundations, which require more-or-less manual input of information and the expenditure of significant cognitive effort to extract meaning from available data.
But as healthcare approaches its financial tipping point and patient-provider relationships become subject to the same consumerization as in other industries, little cracks in the industry’s opposition to change are letting a tantalizing new technology start to peek through. “I want you to imagine something,” said Eric Schmidt, former Executive Chairman of Google parent company Alphabet, Inc., to a packed auditorium of clinicians and technologists at HIMSS18 in Las Vegas. “I want you to imagine a mic and a speaker in a room with a patient and a clinician.” “This system listens to the conversation, disambiguates the voices, follows the consultation, and gives suggestions to the clinician in his or her earpiece. It transcribes the situation so everyone has a record of the complete conversation, and then it fills out and navigates the EHR.” Schmidt calls this virtual clinician “Dr.
Liz” in honor of Elizabeth Blackwell, the first female physician to graduate from an American medical school, and he believes that the healthcare industry is no more than a few years away from being able to put their laptops aside and focus fully on their patients again. “I want you to imagine a mic and a speaker in a room with a patient and a clinician.” A number of the technologies that would support Dr. Liz’s passive data collection and analytics skills are already available, Schmidt said during his opening keynote, and the rest are on their way. Reset paint tool sai to default on a loan. Many were on display, in one form or another, in the vendor halls at HIMSS18.