In recent Holon blogs, our team has written about the innate design theory we have around scaling and capacity. We’ve addressed it from perspectives of people, of process, and of course, architecture and deployment of our solutions. Hopefully, readers have had the themes resonate – one way or the other, if you have been in or around the HIT business long enough, similar problems (goals?) have happened on your watch. But – as much as the ability to “go big or go home” is the emergent task everyone seems to relate to, we’re experiencing something on the opposite end of the spectrum.
As we move through various opportunities in our customer base, we’re experiencing the reality of what it means to bring new process and data into a clinician’s day, and that reality roughly translates to end-users saying, “do as little as possible to my world.” Our challenge at Holon is how to do that with our customers and partners, yet still advance a solution to a problem at hand. Talented vendors work hard every day to bring new applications to life, yet so many of those apps never go beyond prototyping or beta. Why is that? I posit that we are creatures of habit, of patterns, and we don’t like large scale change. We handle change best when we can absorb that change in small amounts, and still operate otherwise the way we know.
When we walk through the workflow scenarios related to providing clinicians with the data they need to garner a better awareness of the patient’s care management, it becomes obvious that issues are frequently not about the data existing. In health care today, under the pressures of value-based care, there are many creating appropriate analytics data and making it available in tools they offer to clinicians. As I say, it’s not about missing data… it’s that the data exists in form or space that is not compatible with what that clinician is currently doing.
The problem is that when you ask a user to depart from a known process, to make a workflow change and do something else, if the impact is unacceptable to that user, adoption dies on the vine. Especially if that user, e.g., a clinician with a window of 15 minutes for a wellness appointment, is under pressure to get far too many other things done that already are on their list. Now compound the challenge by insisting that a means to an end (awareness of external but relevant clinical information on a patient) may involve multiple steps and decision points that interfere with even the most tolerant end-user. With a bow to my colleague Julie Mann, the data may be “liberated”, but it was freed to a deserted island, and almost no one swims that far, or at best, fast enough to get there in time to make use of it.
So, what can be done at a minimalist level, that can provide this awareness of the data the clinician needs, dare I say wants, and not put onerous new requirements on them that force them to make a tough choice? What is small in change (and effort), yet large in impact? Take the use case of presenting care gap data on an ACO-managed patient…. The answer is to minimize the change to the clinician’s work through the Holon Insights solution.
With Holon Insights:
Instead of this, without Holon Insights:
|Use EHR and portal to access analytics platform
While we have written blogs about the scale of deploying something to many users and building support for an architecture that must process countless transactions on a regular basis, Insights helps clinicians provide better care management by letting them do the absolute minimum. In effect we are scaling down to the smallest thing we can manage. Defining absolutes can be tricky, but it’s a safe bet that if you say to someone “just keep doing what you’re doing,” you are defining a minimum change from their perspective.
Insights is built to bring the analytics to the clinicians in such a way as to avoid disruption, and to allow the fullest focus possible on a patient. A recent blog by Keith Loria in the publication Medical Economics states in part that a provider interviewed reported that “… he spent about four minutes of keyboard time for every minute of face-to-face time with a patient.”
With Insights, the clinician works within their EHR as normal, and if data exists for a patient (based on that chart being accessed), Insights pops up a simple alert, and the relevant data is there immediately. No portals, no logins, no searching, no departure from the conversation in the exam room. True, Insights is a separate application from the EHR, but it presents in a visually integrated fashion, with a design that supports the kind of streamlined work that enables a clinician to make use of data outside their EHR yet doesn’t pull them out of that very system. For our team of innovators at Holon, our user experience is intentionally designed as a “less is more” solution.
If you or your clinician community would like to preserve or improve your provider-to-patient experience while enabling delivery of additional information pertinent to the world of value-based care, reach out to Holon to hear about our Insights application, as well as other tools we have developed with our team of talented experts. Thanks for reading.
Jim Tropauer leads healthcare services development and expansion at Holon. Educated as a biomedical and electrical engineer, he spent several years working in aerospace and related information technology companies. In 1998, he joined McKesson where he spent 8 years in various implementation and management roles. Jim later joined the start-up Novo Innovations in 2006 to build both teams and processes for the data exchange solutions portfolio. After Medicity acquired Novo, he continued to lead data exchange services teams,then took on leadership of Medicity’s integration services in 2013.