Safety

How physicians can support better technology development

Hospital Safety Insider, April 22, 2021

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By Megan Headley

Healthcare technology innovation is moving faster than ever as technology companies push tremendous disruptions into this critical sector. However, these disruptions often fail to acknowledge existing workflows and how best to support clinicians. As every physician who has bemoaned the time demand of entering data into EMR systems knows, when technology solutions address a given need, they often create other challenges.

Often the blame goes to a lack of interoperability—the ability of information technology systems and software applications to communicate, exchange data, and put this exchanged information to use. Ideally, data exchange standards would allow data to be shared across clinicians, labs, and facilities, regardless of the application or software vendor.

“We see this phenomenon [of interoperability challenges] all the time, and the root cause is lack of communication,” says Dr. Jeffrey Zavaleta, a board-certified anesthesiologist at Cook Children’s and chief medical officer at Graphium Health, a software provider for anesthesia practices.

From Zavaleta’s perspective, a lack of communication is often due to siloed departments. While physicians, administrators, and IT professionals may be looking at the same problem, they are likely interpreting solutions through different lenses.

Interfaces (the languages and codes that programs use to communicate with one another and their hardware) are fraught with examples of incomplete communication, Zavaleta says. “Interfaces, in general, are real solutions to system integration, but interfaces alone make the job more difficult. There has to be operational infrastructure, processes, and human resources to support interfaces.”

While it is easy to point the finger at technologists, clinicians can play a critical role in helping tech companies develop solutions that take their operational processes into account. Effective relationships and collaborations between technologists and clinical practitioners demand two factors, Zavaleta says: respect and shared interest in data.

“Too many times either physicians lack respect for the real technical obstacles (while ironically being unable to remember their usernames), or technologists lack respect for real clinical nuances that impact workflows,” he says. Yet, “where there is mutual respect between technologists and clinical practitioners, and where there is a shared interest in turning data into actionable information, collaboration between these two parties tends to thrive.”

Once clinicians have the right mindset in place, Zavaleta offers a few additional tips to help them maximize the usefulness of any technology collaboration. First, he suggests that physicians take time to not only describe their typical workflow in detail, but also dig into why the work is done that way. These details will identify areas for improvement and pinpoint aspects of the workflow that should not be adjusted. If there are gaps in knowledge about why things flow a certain way, that’s important to highlight as well.

Zavaleta also suggests that if physicians have a basic understanding of coding, they’ll know better which details to communicate to technologists. “From personal experience, I think it helps by orders of magnitude for the physician to have some knowledge of coding and what software can do,” he says. “While anything is possible, any development comes down to cost: cost to develop, cost to support, and ability to sell.”

That is the last critical factor to consider in the development of new tech solutions. You can shoot for the moon with features, but any solution must provide a solid balance of value and cost-effectiveness.

“Many times, a given feature request for interoperability may not necessarily create value for the paying party,” Zavaleta points out. “A great example in our industry is anesthesiologists requesting vital sign integration with anesthesia machines. While it may make life a bit easier in the OR for documentation, it comes at significant expense to the hospital. It is then important to confirm if this interoperability feature is worth building and supporting.”

Another challenge he is working to address, Zavaleta elaborates, is building user interface features to help anesthesia providers correctly document their individual care times. “The problem seems simple on the surface, but as you dig and find nuance, you realize making a simple and intuitive solution is quite difficult,” he explains. “The goal is to build a user interface that presents a true time error correctly and offers a suggestion to fix it. This makes the billing team more efficient, reduces rejected claims, and reduces fraud.”

Striking the proper balance during product development—a balance between time-saving features and low cost—is the key to business success, Zavaleta advises. “It absolutely requires clinicians and technologists to have some shared vocabulary and, as mentioned above, a mutual respect for the challenges facing each party.”

Megan Headley is a freelance writer and owner of ClearStory Publications. She can be reached at megan@clearstorypublications.com. This story first ran on PSQH.



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