A conversation about how care teams can combat information overload
HIMSS defines interoperability as “the extent to which systems and devices can exchange data, and interpret the shared data.” When we talk about “systems” in this context, we usually mean computing platforms. But the data exchange doesn’t terminate at the front end of a computer application – it actually ends in the brain of the human who is consuming the data from that application.
As systems become more interoperable, more data become available to the human brain. This is a good thing – but it can pose new challenges for the clinicians who interact with an ever-increasing amount of healthcare data. In order for interoperability to truly benefit patients, the data coming out of the exchange needs to be efficiently actionable by the healthcare providers who will use it. We think about this a lot at Arcadia – it’s one of the reasons that modern, user-centered design is a key part of our Arcadia Analytics platform.
We recently sat down to talk more about interoperability and information overload. Rich Parker, MD is our chief medical officer, and has spent a good part of his career thinking about how to make information actionable and useful to practicing physicians. Jen Polello, our director of product training, recently wrote about the need to empower care teams through analytics to bring the joy back to practice. We started off discussing information overload and the brain, and wound up talking about how care teams can use patient registries…
Jen and Dr. Rich, thanks for talking through this. So is it fair to take this broad view of interoperability? Can we consider the human brain an interconnected part of the systems exchanging data?
Dr. Parker: “Well, to me the specific problem impacting physicians is one of information exchange overload, not interoperability. It’s a misnomer to characterize this as an interoperability issue. Interoperability is one EHR communicating with another. But, too much input electronically is a good issue to tackle and a serious problem that deserves attention and improvement.
While this isn’t an interoperability problem per se, it’s interesting to think about the brain as being part of the larger ecosystem of data. We have to think about doctors as human beings and recognize that their minds, like ours, have strengths and weaknesses. If you throw a colossal amount of information at a human, they will miss things. Just because we sent it to you and we know you clicked on it, doesn’t mean you understand it.”
And our brains do get exhausted trying to process an overwhelming amount of information, especially when the stakes are high. Is this contributing to physician burnout?
Jen: “Yes, I think so. Physician burnout was a theme at the IHI conference recently. A lot of healthcare organizations are feeling the pain, because it is so expensive to replace and recruit physicians. All of these issues are plaguing family practices, where you have physicians and other providers who feel like they are typists and receptionists. They are spending too much time on administrative tasks. It’s not just a concern about data entry, though – to your point about the limitations of the brain to digest a colossal amount of information, that’s a problem too.”
What does an organization need to do to combat this?
Dr. Parker: “You really need to get physician thought leaders in the room and have them explain what helps them and hurts them. This is the only way to figure out how to clear it up and stop all of the clutter.”
Jen: “We talked a lot about ‘putting the joy back in practice’ at the IHI summit. One way to put the joy back in practice is to reduce provider workloads and make better use of team-based care. The care team can process and make sense of a lot of different information, so that the physician sees it in a more structured and more efficiently-digestible manner.
Medical care is a team sport now. Organizations need to put this work back on team-based care – and individuals on the care team need to assist the provider. Now, team sports are better, but more complicated: How do we get the right information to the right place, the right person and at the right time?”
Dr. Parker: “And there needs to be balance between the members of the care team and their capabilities. Technology can help balance the work so that members of the care team are working at the top of their licenses.”
If an organization is in the throes of combating physician burnout and turnover, it seems like it would be hard to carve out the time and energy required to make the switch to a care team model. How can organizations make this shift operationally – especially given that it requires an investment in technology as well?
Dr. Parker: “Matching the technology with the strengths of the team to unburden the provider is still a struggle, so any progress in a clinical setting requires a good IT marriage. That is the bedrock principal. IT without clinical input, or vice versa won’t go anywhere. Every practice is different, but every practice requires an investment of people and capital to make this happen.”
Jen: “Having an engaged team across the organization will further any strategies to move toward a care team model. The organization really needs to think about the processes a care team will follow to deliver care, and the information they will need at every step of the process.”
In your experience, when you make information available to a care team, what are the success factors that make that information actionable?
Jen: “Any analytics platform you use needs to empower the entire care team to look at how they deliver care proactively. All of these things take the burden off of and help to empower the care team. You need buy in from the team to make this happen.
From the standpoint of Arcadia Analytics, we are deliberately set up not to badger providers with incessant alerts, reminder and prompts. Within the practice, we provide the tools for a quality program or nurse to work care gaps, reducing the amount of work for the provider. Indirectly, we reduce the burden on the doctor and put it back on the practice.”
Dr. Parker: “With our registries and pre-visit planning, Arcadia Analytics can proactively look at an upcoming patient and decrease the number of alerts that can stress out providers. We do this by looking across all their claims and clinical data sources to figure out where there truly are care gaps, and we can then provide the right information at the right time so it is actionable for the provider and the patient. This means the encounter is more meaningful and actionable.
When you do not present the right information at the right time, but rather flood a physician with data, you create an untenable tension for the human brain.”
Jen: “The key is to use technology in a way that supports our brains – and the interactions providers have with patients.”
Rich Parker, MD is the chief medical officer at Arcadia Healthcare Solutions. Jennifer Polello, MPHA, MCHES, PCMH CCE, is the director of product training. Alyssa Soby is the strategic marketing manager.