By Matt Phillion
With advances in how data is managed and communication is handled in healthcare, it might seem like the time physicians spend with patients has become more streamlined than ever. Instead, physician/patient time has remained relatively constant, while new technology has in many ways added to the physician workday.
According to the Medscape Physician Compensation Report 2017, primary care physicians spend about 15 minutes with each patient, and what they cover is extensive—an average of six health concerns per visit. Now, with digital care delivery in the mix and the complications of a pandemic, burnout has become a major problem for physicians. So how can the industry make sure that technological advances help physicians make the best use of their time with the patient and look for the most important data points during each visit?
“One of the things that was not accounted for as we moved into a more digital age is that we have more access to data, but how [physicians] interact with that data and how they get to it is clunky, requiring multiple clicks to get to anything,” says Celia Whatley, vice president of product management at Lightbeam Health Solutions. “Nothing is in the same place. It seems like everything is digital so it should be so much easier, but the reality is it’s in disparate locations.”
Health systems can subvert this challenge by bringing key information into one area that’s easily referenceable for the provider or care manager, as opposed to asking them to navigate to different locations for the information they need.
“Healthcare administrators are more bullish about technology and how it will ease the burden at the provider level,” says Shelley Davis, vice president of clinical strategy with Lightbeam. “Even with the rise of electronic health records (EHR), it has tremendous value, but the promise to providers was that it would significantly improve their ability to deliver care.”
Some EHRs remain clunky, requiring the provider to navigate through multiple screens, which can add rather than streamline work. Because of that experience, Davis notes, the technology can be an obstacle for physicians required to interact with it. Add to this the constant stream of information and interactions interrupting the physician’s day, like pagers going off (yes, they’re still in use) and being pulled aside for sidewalk consults by concerned nurses or other physicians, and it’s easy to see where the fatigue stems from.
“There’s an incredible amount of stimulation coming at them on a day-to-day basis,” says Davis. “And often they spend hours going back through the record to make sure they’re doing everything they need to do.”
Lightbeam’s platform brings much of that information into a single source of truth, where physicians can see everything they need in one place, so it “becomes very actionable,” says Whatley.
Fatigue and burnout
From a physician standpoint, Davis says, “What’s intended is for all professionals to be working at the top of their licensure. We specifically look at nurses and paraprofessionals. Nurses are expensive: How can we best use those folks at the top of their skills?”
Physicians have the same goal in mind—they want to impact the patients, but don’t want to be bogged down unnecessarily by administrative tasks.
Alert fatigue plays into this issue in a specific way. “The liability for the nurse is if I alert a physician of an issue, the physician now has to do something about it,” says Davis. “If someone didn’t show up for an appointment, the physician needs to step in and act on that. It’s information overload and compassion fatigue.”
Adding to the problem is the increased focus on value-based contracts. “They illuminate the journey to getting better outcomes for patients, but on a day-to-day basis the things you have to complete” as part of those contracts add time and energy drains to practitioners’ days, says Davis.
“They involve so many more things physicians have to check a box on. They’ve been doing this all along with patients, making sure they have the appropriate care, but now there is an additional administrative burden,” says Whatley. “Now tie into this how much more information physicians have available to them.”
In the past, providers generally only had to deal with the clinical documentation from their office and potentially office visits, says Whatley. Now, population health has opened up the door for data from all sides of the patient’s journey. “Providers and caregivers have so much more data they need to review and act upon for the best care,” she says.
“Even just the way the retail space has moved into healthcare—we never would’ve thought that Amazon would move into the pharmacy market or CVS would deliver urgent care in stores,” says Davis. “Before, patients would go to the family doctor, and now patients are getting care in places that are not healthcare centered, which gives us the ability to pull data from so many different locations.”
Use of face sheets
Loaded with information from an ever-widening array of sources and more formalized checkboxes than ever, practitioners can benefit from a centralized location to manage all of this data.
“We get data from many different sources and aggregate it into a point of care tool called a physician face sheet,” says Whatley. “The provider really has one single place to go to view everything that has happened with the patient.”
The tool offers a quick-access, more longitudinal care record for physicians and care managers.
This can benefit specific arenas, like management of chronic conditions, by allowing physicians to view the entirety of a patient’s data without having to go into the EHR.
“We have an estimated one in four patients with two or more chronic conditions, and we need to prevent poor health and costly hospital visits for those patients,” says Whatley. “When we look at the population as a whole, 2022 to 2031 will be a peak for baby boomers, and there are concerns about how we’re going to take care of all those patients and do it adequately.”
“I think Lightbeam does a tremendous job capturing all that information and mapping it,” says Davis.
A patient might be seeing a cardiologist, pulmonologist, and rheumatologist, which is complicated enough to track. But then add consumers getting their medications, dermatology supplies, or any number of care-related items through Amazon or other retail services, and the overall picture grows even more complex.
“There can be very real side effects and interactions from the medications these patients are obtaining from different sources,” says Davis. “I can’t stress enough the benefits of getting all that information into a single view.”
That single-pane view also enables tracking things like missed appointments so physicians can follow up and discuss these things while the patient is in front of them, surfacing the most important information instead of burying it in a sea of documentation.
“At the heart of care management is the premise that you’re doing the right thing at the right time and in the right place for the right patient,” says Davis. “It’s ensuring all those things come together.”
“One of the key things is finding that right patient inside the system,” says Whatley. “Because we aggregate all the disparate sources of data, de-dupe and clean it up, we have the ability to go in and identify the right patient. It’s not just looking at the clinical record of this patient and seeing they have diabetes—they might have an anxiety medication prescribed from outside that organization we need to know about.” The face sheets pull those key points to enable optimal management of the patient’s needs.
Future impact on patient care
Lightbeam has a clinical transformation team of RNs who engage with users, thought leaders, and decision-makers as well as providers. Team members strive to “find out what’s working, how they use the system, so we can bring it back to the team,” says Davis. “It’s a constant evolution.” Focus groups help uncover means to further streamline the system for physicians and care managers.
“If 2020 taught us anything, it’s that nothing replaces the human touch, but it also taught us about the ability for false information to cascade very quickly,” says Davis. “One of the things we solve for is how do we keep the real-time actionable picture for care teams, so they can educate the patient as quickly as possible so [the patient isn’t] following advice that isn’t evidence-based.”
Removing the barrier of disparate data sources opens the door to future improvements on the care side, Whatley says.
“Where we go from here from a tech standpoint is incorporating more machine learning,” says Whatley. “We already have the ability to look at outcomes and which interventions have been most effective, but we want to take that to the next level. Now that we have more of a streamlined approach and a quick and easy way to access data around the patient, I want to do more with that data to know what works best.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at firstname.lastname@example.org.