Pondering this question for me has been quite a challenge and I’ve decided it’s primarily because I’m not sure we’re “there” yet. Maybe a better question would be: “What could be the value of Health IT? And for me that question has a simple answer: “Moving the Bar” i.e. improving patient care in a way we’ve not previously experienced.
Yet in order to achieve that goal, we have to change how we work, how we think, and how we solve problems as clinicians. We have to use data as a tool and welcome data as an indispensable component of our clinical success just as we would a stethoscope or an x-ray. We cannot continue to view EHRs and technology as obstacles to be overcome, or as governmental mandates that interfere with how we practice medicine. Technology and the data it provides are Godsends; truly gifts to medicine that can transform how we care for patients and improve lives.
If only we have the vision and wisdom to use them.
Imagine with me if you will, of a day in the not too distant future, when a physician could sit down at a desk and pull up a list of his patients with a diagnosis of Type 2 Diabetes, with HbA1c levels over 8%, and see what percentage were on DPP-4 inhibitors. Next he might want to graph their A1c levels over time and see if there has been any improvement. Finally, he might choose to send those patients on his list who have not been seen in six months a letter asking them to schedule a recall visit in his office for follow-up, and assess them for a possible change in medication—all from his desktop.
This ability, for a single practitioner, to quickly and effectively manage a population of patients, comparing and contrasting treatments, costs and outcomes is a “game changer.” It can inexorably alter the way we practice medicine. It can lower costs and improve care.
It will move the bar.
And most interestingly, that day in the “not too distant future” is not distant, it is today. This technology already exists in the decision support tools available with many current EHR systems. It is real. It is tangible. It exists.
But it is not being used.
And the barrier to adoption seems to be us—the clinicians. Perhaps it’s our schedules, or how we were educated, but we tend to focus on each patient at a micro level; what’s wrong right now: what are the symptoms, what is my differential diagnosis, what tests do I need and what treatments do I prescribe, what do I need to do to make this patient better right now?
And then, on to the next patient…rinse and repeat.
The leap here is that we need to take a step back, and take the time look beyond the single patient to populations of patients. Most of us have never thought of medicine in this way; we were never trained in treating populations or even thinking about them. It’s not in our “black bag” of tricks.
We have to change how we work, how we think, and how we solve problems as clinicians.
The challenge is ours and our profession’s. The tools are available now. The technology exists. We need to embrace it and search for new and innovative ways to leverage the information we have at our fingertips. We must pick up the metaphorical “digital stethoscope” and use it. Only then will we realize the true value of Health IT.
Let’s move that bar together.