With the spread of the “Covid-19” pandemic, the use of telehealth technologies has increased dramatically, which places physicians more burdensome due to the requirements of health information technology and electronic health records systems (EHR) in particular.
Therefore, the capabilities of future technologies for telehealth must be designed. Taking into account the needs of physicians, in order to increase the interaction of physicians with healthcare technologies, which guarantees to improve the care that patients receive without contributing to the increase in the physicians’ burnout.
Digital Transformation in Healthcare Service Delivery
The healthcare industry is undergoing a major transformation process, consisting of a combination of legislation and attempts to quickly adapt to the new incidents, like Covid-19 pandemic and other healthcare sector developments
This trend was more evident through the rapid expansion of telehealth services. In the USA, telemedicine visits in the first half of 2020 have dramatically increased and reached almost 2,000% growth when compared with former periods.
The possibility of enabling patients to have healthcare services while being at home through their computer or smartphone devices was a life-changing concept and very impactful to have such services anywhere anytime via phone calls, video calls, or chatting.
Although the Covid-19 pandemic has caused some of the toughest challenges, it is clear that it has also brought some of the best features of healthcare organizations, it has developed new capabilities for agility and innovation in healthcare services provided to be more adaptable to the current situation.
Providing Telemedicine or Telehealth services is a nice idea but we still don’t know its impact on patients or if patients will consider it really beneficial to them or not. The adoption of patients in many places is still a challenge in the Middle East and Africa region due to multiple reasons.
Some people might see telemedicine as an innovative solution with better access to care anywhere especially for those who are living in suburban, rural areas, or far from healthcare facilities, this technology can save time and money.
For other people, it will mean also better access to care that was previously impossible for reasons of restrictions on movement, long distances, and other prohibitive costs.
But it does carry risks that include the possibility that traditional diagnostic and examination results will not be forthcoming. This reflects the current culture that people are more trustful in the conventional way to get the service, they may not feel confident in getting a distant service without a real interaction and physical examination.
What was mentioned was from the patient perspective, but we should mention the second important part of this cycle who are the physicians, will it be beneficial to physicians assigned to provide healthcare services?
For some physicians, it will mean relief from the hassle of daily going to the workplace and saving the time of transportation to healthcare facilities, and also remote working or working from home can be safer and more convenient especially during the pandemic.
But the study of more than one million telehealth consultations revealed that telehealth has increased the burden on physicians by doubling the working hours per week, and physicians have to do the bulk of work at night and during weekends, while questions persist about the consequences of providing telehealth services for malpractice claims.
Of course, the widespread adoption of telehealth services is the result of dire need, but if it is need or invention, are all inventions successful? The answer may depend on our perception of success.
Are Healthcare Technology Vendors Just Seeking Profits, not Convenience?
We can start the answer to this question with the evolution of the Electronic Health Records (EHR) systems, although it has a lot of benefits to workflow management, adoption of electronic health records (EHR) was limited in its early stages due to the high costs of the technology and the low utilization rate.
Therefore, the Health Information Technology for Economic and Clinical Health Act, symbolized by the acronym HITECH, was able to solve the problem of low adoption of EHR systems through putting new legislation.
The law succeeded, as by 2017 96% of hospitals in the United States were adopting certified electronic health record systems.
That also triggers for making a better adoption of HIT in MEA healthcare facilities should be driven by policy makers and legislations.
But one unintended consequence of this rapid adoption is that electronic health records, originally created as a catalyst for better patient care and physicians ‘well-being, have become a major source of doctors’ depression.
This phenomenon was described in a recent study to assess the possibility of using electronic health records by means of the System Usability Scale, referred to by the acronym (SUS), which is an approved tool designed to measure the efficiency, effectiveness and degree of satisfaction with electronic systems. The google search engine got a grade (A), i.e. very good, while the oven (microwave) and the automatic teller machine (ATM) got a grade of (B), meaning good.
Electronic health records got a rating (F) by its users who are physicians which means a bad rating.
Most importantly, the use of EHR technologies is highly related to the job burnout experienced by doctors.
the healthcare IT sector did not have sufficient time to automatically address the usage problems associated with these systems and the user experience.
Today, we have strong but outdated systems that have moved healthcare to digital operation at the expense of the relationship between the doctor And the patient.
Over time, electronic health records have also become increasingly complex. As each additional requirement emerged, such as compliance with billing requirements and the increase in patient numbers, electronic health record technologies expanded to include new capabilities.
But the tool’s design has long lacked a key component of fully understanding how it affects healthcare providers and namely, physicians.
The development of EHR systems and their additional responsibilities turned into burdens on doctors.
The problem is not that the EHRs are not perfect, but rather that their deficiencies affect physicians to a large degree.
In fact, 70% of physicians who use EHR technologies report suffering from HIT-related depression.
If the intention is to improve satisfaction with patient-physician interactions, these results have not yet materialized.
In fact, studies reveal that physicians spend twice as much time in front of their screens as with patients.
Essentially, the healthcare sector blew up a volcano of technical problems due to the speedy implementation of a technical solution, spending the next decade trying to get things back on track.
The Revolutionary Technology in Healthcare Communications
Recently, the digital communications revolution in the healthcare sector has been accelerated greatly by attempts to increase patients ‘access to their physicians’ services and medical information.
The most common example is the patient portal and the in-basket service, a tool that a patient can use to send messages directly to a doctor’s inbox.
The advent of digital patient portals and direct communication with physicians raised expectations of online service availability to a large degree, making it more difficult for doctors to stop working in front of computer screens.
Not surprisingly, receiving a greater than average number of direct patient messages was associated with a 40% increase in physicians’ likelihood of developing job burnout.
Now, patients have more expectations in physician’s availability all the time to respond their messages and inquiries that pushes physicians to a higher workload and working extra hours to clear all the pending tasks.
There is a redesign of processes required to overcome these challenges like setting clear expectations for patients with the availability of physicians and their response, developing cultural norms regarding EHR use is essential in managing expectations.
the involvement of nurses and paramedics in managing the inbox may be crucial in helping to sort the cases that need the physician’s intervention and distinguish them from those that can be managed without him.
The rising potentials of healthcare IT technologies including chatbots, AI and smart electronic health record systems can help reduce the workload of doctors.
However, as we worked to reduce the volume of messages that reach the inbox, a central question arose for us, which is: Should we continue to accelerate the implementation of products and legislation without following measures that protect our largest and most vulnerable assets, who are, healthcare workers themselves?
The design of the new healthcare information technologies should consider physicians as much as patients to come out with a true technology that achieves the meaningful use.
Consider the Following Principles While Developing HCIT solutions
The coming years in the healthcare sector will be marked by more sophisticated electronic health record systems, increased digital access to patients, a significant increase in personalized care, and widespread adoption of artificial intelligence.
They will all be necessary tools in the new era, and the consequences of developing using these technologies will be unknown. Ensuring that these tools fulfill their intended purpose takes us to think from the perspective of its users.
New interventions must incorporate thoughtful design that takes into account the impact of innovation on all key stakeholders, including physicians.
There are important considerations that healthcare technology vendors should consider while developing the future solutions
Develop patient centered solutions
Remembering this primary goal of health information technology can help ensure it remains safe, effective, and efficient.
Technologies should achieve the meaningful use for patients who is the center of the healthcare service.
Assemble a Team with the Right Talents:
Successful design will require the contribution of a variety of perspectives and skills. It will require a careful interaction of experts in the areas of human factors, finance, population health, well-being of doctors, and more, in order to ensure the innovation process is effective, sustainable, and supported by various stakeholders.
Ask the reasons without stopping:
Asking why do things a certain way helps ensure that health information technology is not caught in a vicious cycle that business as usual creates.
Stick to simplicity:
Following the principles of human factors and user experience can help come up with an automated and user-friendly design.
Don’t get caught up in the whole part:
Assess the potential unintended consequences of human and technical interactions with each design modification.
Explore problems, not solutions:
Usually, healthcare design focuses on reinforcing solutions before real problems are recognized. Therefore, it is essential at each stage of the design process to reassess the fundamental problems that the proposed solution aims to address.
This will help avoid falling into the solution-making trap for solution-making.
Finally, it is imperative to remember that healthcare technologies do not exist in a vacuum. So, you should look at other sectors that have successfully implemented user-centric designs. Remember that more than 40% of physicians suffer from job burnout, so a lot of issues hinge on our success in increasing physicians’ interaction with healthcare technologies.
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