Why Automation?

In what ways can #HealthIT work w/physicians to improve the #EHR experience? What would you change? #HITsm

This is a great question, and I’m glad that people are asking! One of the biggest frustrations physicians have is that we feel like we were left out of a lot of the important decision making conversations in regard to EHR adoption. Now we have systems that were mostly chosen for us and we’re trying to make the best of it.

So, my first answer is to keep asking front-line physicians questions. I believe there needs to be a continuous feedback loop as to what our needs are, what is working, and what is not. Another great question to ask regularly would be, “how can we design Health IT to augment your clinical experience?”. Then, make sure it really does work for us before rolling it out on any kind of scale. Remember that we are all unique, and one-size-fits-all solutions fit nobody very well.

My co-founder and I started a company that automates repetitive tasks in the EHR because we got tired of pushing the same buttons over and over again. But, what if the system was designed from the ground up with the way a physician thinks in mind? What if you put that together with the metrics that are important to quality care? What if a primary goal of your EHR was to make you life simpler? Future EHR’s are going to be much better embraced when they are built with ideas like this at their core.

I think it’s time for EHR vendors to get into the trenches. I would like to see more R&D labs with clinicians and tech teams working side-by-side as they see patients in the real world setting. That’s how you find out what actually works best where the rubber meets the road. It’s also how you find out where the wheels come off. I would love to see an automation platform like SwiftWire integrated into EHR’s so more of us can get our work done with less effort. That would be real innovation!

To summarize, these are my three big ideas:

  1. Keep asking us questions, develop feedback loops, and iterate changes
  2. Cooperative R&D labs between Health IT and physicians (leverage everyone’s best experience and intelligence)
  3. Integration of solutions that make our work faster and easier
  4. Thanks for asking my opinion. Hit me up anytime with more questions or comments.



Medicine 2.0 — The Situation at ‘Cheese Station C’ has Changed

I am Haw.

Anyone who has read the classic, “Who Moved My Cheese?”, by Spencer Johnson, M.D., will get this reference. If you haven’t read it, I’ll give you the short version. Medicine is in a huge phase of transition. Some people probably saw it coming. I had an idea about it, but nothing close to the palpable reality we are living today. Our Cheese has moved. The traditional model of medicine is changing before our very eyes. New technology, new payment models, new culture. So many moving pieces, it’s almost impossible to keep track of them all at once.

In the story Haw is a ‘little person’ living in a maze with his best friend Hem, and two mice named Sniff and Scurry. He sees that the Cheese is gone, and is trying to figure out his next move. Hem is the burned out physician I watched spend his day yesterday on Twitter ranting about the current state of EMR technology. And he’s not alone. There are 1,000’s of Hem’s out there. They are my friends and my colleagues. It’s painful to watch. I wish we could go back to the good ‘ol days… We can’t. The Cheese isn’t going to come back.

Sniff & Scurry didn’t know if the Cheese was coming back, but driven by instinct, they saw it wasn’t where it was supposed to be and immediately started looking in the maze for new Cheese. All you needed to do was to go to the HIMMS conference in Las Vegas this year to meet Sniff & Scurry. People know there are giant pieces of Cheese in this maze of modern healthcare. Sniff & Scurry are the people who will try whatever it takes to get their piece of it. And they will.

I want things to be better.

The beginning of this post probably comes across without much hope. That’s not my intent. I think one needs to understand the background clearly before moving forward. Healthcare is anything but hopeless. It’s a field made up of some of the smartest, hardest working, and most compassionate human beings on the planet. This is my call for us to wake up to our new reality. Stop fighting for the old paradigm. I said it before, it’s not coming back.

I’ll leave you with some inspiration I heard this morning listening to ‘The Doctor Paradox’ podcast. The guest was Daniel Meltzer, MD. His message is one of taking care of his fellow physicians. He felt it was so important, he co-founded a system called “Practicing Excellence”, a toolkit for the modern physician to thrive. The tagline, “Advancing the Field of Physician Effectiveness” is a good summary of his mission. I get his drive on a deep level. That’s at the heart of why I’m involved in a Health IT startup. It’s not about making software. It’s about me and my friends in this maze together.

I believe that if we pool our collective intellect, goodness, compassion, and human will, we can save medicine together. Or, more accurately, re-invent medicine and learn to find new Cheese.

The Power of EMR Automation Analytics

Early on in our conversations with Upstream Ventures, Frank was excited about us logging data from SwiftWire. Kirk & I resisted for multiple reasons. It seemed like a distraction from the purity of automation, which we love. It seemed like a vulnerability to have data that could possibly be used in a way that made us uneasy in our guts. And most importantly, we just didn’t appreciate the value it could add to what we were doing. Why divert resources to a side project when we already had a fantastic automation app in our hands that could save physicians and other medical professionals oodles of time?

Fast forward to today. I was a skeptic, I admit it. Now I’m a convert. I’ve been logging my data for the last month, and using charting software to view it. It’s amazing how we can trick ourselves into thinking we understand exactly what we are doing until we have hard data staring us in the face. Before logging, we were always making rough ballpark guesses about how much time could be saved with EMR automation. And, it turns out our guesses were not all that accurate. With SwiftWire Analytics, I can now say with certainty that I save 35–45 minutes per clinic day consistently through use of SwiftWire commands. Kirk just reported to me that he is doing just about the same. Well, actually he reported that he saves exactly 42 minutes per day average. He also took it a step further and projected that this allows him to generate between “$29,340 — $58,680 per year in increased revenue” by using SwiftWire.

Analytics allows for another benefit to us as physicians. We get an honest look at how we are working. I am in clinic 3 days per week, and saw 96 Level IV Established visit patients. The automation tool I use to pull in my progress note template and automate billing for these visits is by far my most used and most valuable command. I intuitively knew I liked it, but I didn’t realize how much more I was using it than my other tools. I was surprised to find that my command used for routing Telephone Encounters to our nursing pool was another big time saver. And, I just love my “Co-Sign All” command. I feel like I’m winning in the game of EMR every time I use that one.

One month in, and I have to thank our mentor Frank for his insight. He definitely knew what he was talking about. This is a powerful tool that I hope many more docs like me can have access to soon. As to my fears, so far they have all turned out to be irrational.