Healthcare IT: the frontline physician search for better solutions


I recently gave a keynote presentation to a large information technology company based just outside Boston. My talk focused on the history of healthcare IT, how we got to where we are today, and the current pain points for physicians. I also addressed the tremendous opportunities for the future and how we can better optimize our current systems.

I enjoyed speaking to this particular group, they seemed like a diligent and conscientious bunch of people, who were committed to making high quality products. They asked some interesting questions, and told me it was one of the first times they had spoken to an actual practicing physician! I found this so very interesting. Here was a superb growing company that was making clinical products for physicians, but—and I expect like the vast majority of technology companies who sell to large healthcare organizations—were not actually speaking directly to the very people who would be using their product.

As a practicing doctor with a keen interest in the intersection of technology, communication, and the human experience in healthcare, I was only too happy to share my perspective with them—especially as someone who has worked with just about every EMR system. I’ve given a similar presentation to different organizations, but rarely to a pure technology company, so it was also good for me to get their take on things. As many of you know, I spend a lot of time writing about the suboptimal nature of current healthcare IT and how we’ve gone wrong, including this article about how, for way too many physicians, the very nature of medical practice has changed unrecognizably for the worse. Look at any current study on the shockingly explosive rates of physician burnout and job dissatisfaction, and you will see frustration with healthcare IT consistently ranked at or near top of the list.

Let me stop right there, because anybody reading my articles may get the impression that I’m some kind of technophobe who wants to go back to the days of pen and paper charts. Nothing could be further from the truth! I love technology. I am a big user of all modern technology including social media, and love the way it’s improving so many aspects of our lives and enhancing connections with other people. But correction: I love good technology. I want to see the technology I use every day in healthcare be as seamless and brilliant as that on my iPhone, touch device, and laptop. We have a long way to go before we get there.

At the crux of why healthcare IT is not where it should be, are the following 3 major obstacles:

  • The physician is not viewed by the technology company as the “end-user” of the product. They are selling to hospital administrations and other 3rd parties. Can you imagine how bad the iPhone would be if they developed their products with no consideration of the end-user, their logic, and how they are going to be using the device?
  • The EHR/EMR vendor is a monopoly once installed, and therefore has no incentive to improve. Not only is this bad for any industry, but it’s also very un-American. Monopolies are never good. Along the same lines, why don’t EHR vendors allow open-access so that other (HIPPA compliant) technologies can build on them and help augment their software?
  • Most EHRs are built primarily as giant billing and data capture tools—not patient care tools.

It’s interesting that when you look around the country, any software which has been built and developed by practicing physicians—is always the most usable and seamless, consistently getting great feedback from both physicians, nurses, and other frontline healthcare professionals who use it.

Technology companies need to be relentlessly engaging with real practicing physicians who also understand IT and how workflow processes should be integrated. A word, too, about the main technology contact within most healthcare organizations: the Chief Medical Information Officer (CMIO). This is a role whose scope has expanded dramatically across the country over the last decade. I know many CMIOs personally, who are fine and dedicated professionals. However, keep in mind that if the people who occupy these administrative positions are no longer practicing physicians (most of them are usually MDs by training), their perspective is going to be very limited. Even if they work at the frontline for a handful of days a month, it will give them a decent level of understanding of what the real end-user needs from an IT solution (in my view, every physician administrator—right up to CEO—should be required to do so, and if any trained physician doesn’t want to, it should raise alarm bells). If a physician administrator has taken the technology career path because they were always “technology minded” and wanted to completely get away from clinical care, they may not necessarily be the best person to act as the main liaison to the frontlines.

There’s so much work to be done over the next few years. Technology companies, healthcare administrations, practicing physicians. All have to work together to find the best possible solutions and end the current debacle of poorly designed systems being foisted on the medical frontline.



Suneel Dhand is a physician, author and speaker. He is co-founder at DocsDox and founder at DocSpeak Communications. Learn more about him here.

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Twitter: @SuneelDhand

  1. February 6, 2018
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