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Putting Physicians at the Center of Technology

Published on 4/19/2017

Today, sophisticated technology is designed to be clinically driven, which means that the voice and expertise of the physician in the development stages of IT has never been more crucial. To that end, we believe there is an opportunity to enhance the physician's technical skill set and familiarize them more with the tools of the trade. Our new Physician Architect Program combines eLearning and in-person classroom learning, allowing providers to obtain advanced knowledge of the Cerner configuration tools and technology so they can better support their organizations.

Cerner client Dr. Paul Fu, CMIO and Pediatric Hospitalist at Los Angeles County Harbor-UCLA Medical Center, Professor of Pediatrics and Health Policy and Management at UCLA, attended the inaugural pilot class for the Physician Architect Program. He sheds some light on the need for initiatives like this and how his experience at the Physician Architect Program positively impacted his outcomes.

Good HIT should simplify the workflow

Jigar: Often, we see that physicians become frustrated with health care technology not because the technology isn't advanced enough, but because they haven't been able to learn about its features or because they haven't had a role in its development and implementation. As a physician yourself, what are some of the ways you've experienced this?

Paul: There's the old joke: "Once you've seen one EHR, you've seen one EHR." I think that's largely true today, even with the increasingly sophisticated systems that are available. Fundamentally, physicians want the EHR to help us deliver better patient care, and we don't want it to make our workflow any harder than it already is. That's really the key — good health care technology should simplify the workflow. It should recognize the differences between discipline-based workflows without eliminating structured data collection.

There are so many ways that health information technology systems can be customized, and this is complemented by the continual updates available for certain technology. Each update has delivered improvements that we've implemented [at Los Angeles County Harbor-UCLA Medical Center], but occasionally, there are even more improvements that remain hidden simply because we were unaware of them. That's frustrating!

The rising demand for user-friendly technology

Jigar: It's no surprise that there's an increasing demand among physicians for solutions and software to be more user-friendly. What are some of the improvements you would like to see implemented at the design stage?

Paul: I think that workflow and analytics are the two biggest areas for improvement. We want our health IT solutions to be user-friendly. On a daily basis, we're seeing patients, delivering patient care and managing our panels. Using customizable or flexible, modular web design interface, that drives you to note templates that are specialty-specific and that creates a workflow that is smooth.

Cerner has told us that we create the most notes with their modern tools across all clients. Part of the reason for our success in that area is because the workflow has been optimized for flexible use. We've adopted an easy-to-use, modular design interface, and have only just started to tap the power of note templates.

We want our notes to be better. We have medical students and residents who need to learn how and why and what to document in a note, not just reproduce everything that's in the chart and include it in the note. We have tools to do that now — to make notes quality notes with the EMR and make it easier for our physicians to save time. Instead of reading through layers of repetitive documentation, we've optimized the system for our specific needs.

For analytics, it's another death by a thousand paper cuts. Often, there are several different platforms that deliver data, some of them overlapping with each other and few of them not speaking to one another. What we'd love to see more of is a data visualization platform that can seamlessly integrate with our workflow. This need is constantly evolving; for example, what we thought about reporting in analytics 15 years ago is night and day compared to what we think about with data visualization today.

Giving physicians a behind-the-scenes HIT opportunity

Jigar: When you attended the Physician Architect Program, what were some of the biggest discoveries you made? How have they improved the way you interact with your current software?

Paul: One of the first things I learned about was the richness and depth of the ecosystem that surrounds the software — especially the documentation. For me, as a fairly technical CMIO, learning about the different tools that our analysts and architects use, getting to use them and seeing them in action downstream really provided a much better understanding of how we might improve our operational efficiencies — for example, how we provision our users. On the whole, learning about the software architecture provided crucial context to how the system really works given the large number of modules.

A few other discoveries I made had instant payoffs. For example, I discovered a simple fix to a complicated reporting problem through a customization option that I had no idea was possible — and, in fact, had been told was not possible. This program helped me learn the fundamentals that provided instant gratification.

Putting physicians at the center of technology

Jigar: There's always more to learn when it comes to health care technology, which is constantly evolving and improving. What do you think initiatives like the Physician Architect Program can do for the physician community as a whole?

Paul: Overall, the more access the physician community has to programs that inform, the better we'll all be. Learning how to build note templates, orders, and order sets was phenomenal, and I now have a much deeper appreciation for how we might leverage them to improve our workflows. The tools are simultaneously labyrinthine and quite easy to use, and are things a provider — given some practice — could develop proficiency with.

If that kind of talk sends shudders down the spines of any CIOs reading this, let me set the record straight: I don't think that every provider should be build wizards. But knowing how those tools interact within a system and what kind of customization is possible has opened my eyes to the optimization opportunities in my own EMR — opportunities that will ultimately drive better patient care.

For those in the physician community who want to be more engaged in the EHR optimization process and who want to learn and develop new technical skills that have a very tangible impact on workflow and patient care, I would consider an architect program — much like the Physician Architect Program — to be highly valuable. It was the single most valuable Cerner course I have taken to date.

Jigar: Paul, thank you so much for sharing your experience and thoughts. I truly value your insight as we continue to improve the Physician Architect Program.

The Cerner Physician Architect Program helps physicians better understand the nuances of Cerner's Millennium software, giving them the opportunity to positively impact patient outcomes. For more information on the Physician Architect Program, contact us.