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What Does Interoperability Have To Do With Letting Doctors Be Doctors?

by Ed Park, COO

A long time ago, a doctor leaned over to me and said earnestly, “Every patient is a story. When my colleagues refer a patient to me, I care mostly about how the story begins and ends – what’s wrong with the patient and what’s your assessment?”

That message has resonated in my head for the last decade and I’ve watched in horror as an entire of generation of EHRs have made an incomprehensible mess of the patient story. I don’t know whether to laugh or cry when I watch this video about two doctors trying to discuss a patient case and needing the hospital cafeteria worker to be the intermediary between them.

As funny as this video is, it highlights a much more serious issue with EHRs: well over half of the documentation in today’s EHRs are for the lawyers, auditors, and insurance companies, not for doctors and patients.

One of the most depressing moments of my career was reading through the nearly hundred pages of guidelines that describe how to document the different severity levels in Evaluation and Management (E&M) visits, the codes that describe the bulk of patient visits in the country. If a doctor doesn’t follow these guidelines appropriately, he or she could be fined or even sent to jail.

As a result, with limited time and energy, most physician notes are focused on defensibility, not clarity. This means that providers are not always documenting to communicate — they are documenting to show their work. It is harder than ever today for physicians to rely on each others’ notes — they are simply too difficult to read.

In theory, interoperability would at least help to solve this problem for providers. At the very least, it would not be necessary to re-document key elements of the patient chart and more time could be spent on telling the story of the patient. Yet in reality, interoperability today often means printing out vast reams of gobbledygook in patient records and faxing them to the next provider. There is no seamless, digital connectivity when it comes to the patient story.

Ten years ago, when athenahealth began building our EHR service, we started off with the intent of creating the world’s first truly usable EHR. Yes, we have to ensure that our doctors can comply with E&M guidelines. Yes, we have to ensure that our charts will pass any chart audit. But as we found, that doesn’t mean that doctors have to lose the signal for the noise.

At the end of the day, what really matters is the story of the patient and how doctors communicate with each other to help the patient be well, not the complexity of the chart. This is why true interoperability and a next generation EHR that lets doctors be doctors is crucial for the future of American healthcare.

With better health IT, we can empower doctors to do what they do best: be doctors. Help us elevate the voices of providers and bring them the technology they need. Join the movement. Together, we can #LetDoctorsBeDoctors.


This post originally appeared on the Health Leadership Forum.


Ed Park is the Chief Operating Officer at athenahealth. 

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Comments

Submitted by william lee thomas - Wednesday, November 18, 2015

the chief barrier to providing health care to my patients is the EHR. the medical record used to be a tool I used to take care of the patient. now the patient is a tool I use to care for the her. the most difficult part of patient care now is EHR medial care documentation. it takes me twice as long to document the patient care in Athena EHR as it does to get the history and do the PE and make a dx, explain to the patient.

Submitted by Dawson Cherry - Monday, November 9, 2015

Spot on, spot on, now carry that message into and throughout your Athena system(from your employees all the way through to your customers) and you will be the Apple of EHR.

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