I attended CHIME’s Spring Forum last week. Much like the ONC’s 2021 Annual Meeting last month, it was all virtual, so while I enjoyed the opportunity to hear from healthcare IT leaders across the world, I was disappointed that I couldn’t spend $7 and 20 minutes of my time for a lukewarm cup of Starbuck’s coffee. Bummer!
At conferences such as CHIME’s, I try to look for trends or industry directions that are new or noteworthy. Last week, I heard about the importance of interoperability, data liquidity, and industry consolidation. All of these are important of course, but these trends won’t be news to anyone in healthcare. While I’m not sure it constitutes an industry direction, one point kept being emphasized by various speakers: healthcare in general (and healthcare IT specifically) must focus on the user experience. Yet, we can’t focus on a single user experience; we must see the big picture and work towards the best user experience for all the different users through all the different aspects of healthcare.
When one typically hears the words user experience, it suggests computer software or hardware. However, when referring to healthcare, I think it’s important to broaden our view of the term to include everything having to do with how people interact with the healthcare system. Of course, users are not just the folks receiving the care; we must consider the clinicians and support staff who deliver it as well. Some examples of such user experiences include a patient trying to schedule an office visit, find their way around a hospital, or purchase a glucometer. On the clinician side, think about a physician trying to order an uncommon test or a physical therapist waiting on insurance approval before seeing an urgent consultation.
David Rhew, M.D. is the chief medical officer of Microsoft. At a (sort of) panel alongside executives from Amazon and Google, Dr. Rhew referenced Microsoft’s recently announced acquisition of Nuance. I’ve always thought of Nuance as principally a voice-to-text company, but most publications are referring to them as an artificial intelligence company. Whatever way you look at it, Microsoft acquired them – from a healthcare perspective – to help reduce barriers to good physician documentation. Dr. Rhew mentioned a three-pronged approach to excellent speech capture: understanding the text, contextualizing it, and seamlessly incorporating the information in the electronic health record (EHR) as a progress note. While the speech capture can happen today, the contextualizing and note incorporation isn’t easy and would certainly reduce some of the workload that contributes to physician burnout.
We also heard from Phoebe Yang, a general manager at Amazon Web Services. At CHIME’s Spring Forum, she emphasized that AWS is focused on centering healthcare around the relationship between the patient and clinician. She spoke about the optimal amount of data and the ideal engagement with information. While big data may be the big thing nowadays, it’s relatively easy to show both doctors and their patients a ridiculous number of test results or vital signs or other pieces of information over time. What’s much more difficult is identifying trends in those data points and calling out interesting or important developments that might be overlooked by non-computers. A great user experience might be seeing every glucose result in the last six months; at a different time, the great user experience will just necessitate knowing if the hyperglycemia has been well-controlled over the last month.
Rasu Shrestha, M.D., EVP and chief strategy and transformation officer at Atrium Health, underscored what’s most important for both caregivers and patients: focusing on the experience as they move through the healthcare system. It’s essential to understand the big picture and work towards user-centered design of the system, not just the EHR and not just for clinicians. We can certainly learn from other industries about best practices for one aspect or another, but ultimately, taking care of people is different than retail or aerospace or finance.
As I listened to many of the CHIME speakers, this message came through loud and clear: while sweating the user-experience details of a particular clinical decision support tool is important, we must not forget to ensure that the bigger healthcare system also needs our attention. We need to examine and improve healthcare on a micro and macro level. Sounds easy to me. Let’s all get to work!