NHIT Week:  A Physician-Vendor’s Take on Health IT’s Impact

By Adam Lokeh, MD

I am a physician that lives in two worlds. In one, I’m a board-certified plastic and reconstructive surgeon specializing in hand, microvascular and aesthetic surgery. In the other, I’m a board-certified informaticist and vice president of clinical development with Wolters Kluwer’s Health division. This dual-role has provided me with a unique front-row seat from which I have watched - and experienced - the rapid evolution of health IT.

TabletTechnology has most significantly impacted the clinical side of my life, both personally and professionally.  Patients can now access and review their own medical results, which helps them to be more engaged. I really see and feel the impact of this with my family members. When granted access to their health information, I’m able to get a reasonable idea of what is happening with their care, which I can more effectively communicate to them so they, too, can be more actively engaged in the process.

As a physician, technology gives me access to massive amounts of information on my own patients. This is particularly useful when I’m seeing a referral because it allows me to minimize the resources expended piecing together the patient’s “story.” I can glean a reasonable idea as to why they are being referred to me, what has been done in the past, and what has and hasn’t worked. Similarly, when I take a call from the trauma center I work at, I can remotely view imaging studies, review lab results and clinical notes, giving me a much clearer picture of the case. This broader access to information has been invaluable, speeding up care decisions and eliminating the chance the patient will need to endure inappropriate or duplicative testing or treatments, or the wrong action being taken on their case (e.g. transfer to the wrong facility type, inappropriate admission or discharge).

Secure communication by text, email and EMR messaging is another area where technology really shines. It has simplified my day. I spend less time on the phone or driving from clinic to hospital and back. Patients have shorter wait times, and my care is more efficient.

I can attest from first-hand experience that patients get better care when information is at our fingertips. Before EMRs and clinical decision support tools, patients were completely dependent on what lived between physicians’ two ears. If a physician didn’t want to spend the time researching best practices or, worse, didn’t recognize they even needed to, it was the patient who was taking the chance.

In fact, the vendor side of me is most excited by the propagation of patient data and clinical decision support that can now be delivered straight to physicians at unprecedented speeds. It’s powerful, but also frustrating, because we haven’t seen that happening on a sufficiently large scale to truly impact patient care. We have the ability to do amazing things with our smartphones, but our EMRs are still stuck in the 1990s.

Consider the incredible explosion of technology over the last 25 years. I can FaceTime with my family on the other side of the world, turn on my house lights using an app, and have car troubles diagnosed via satellite/cellular transmission. Yet these type of advances haven’t truly yet made it to the world of medicine.

Healthcare technology has perpetually lagged behind other industries. I can’t imagine what it would be like if, because my computer runs on Mac OS instead of Windows, I was denied access to certain webpages or other online resources. Yet that is what happens every day in hospitals and practices nationwide because of the profound lack of truly functional interoperability between EMRs. 

There are days when I feel the lack of interoperability more than others; when I’m struggling to gather together bits and pieces of information on a patient from multiple departments and/or organizations. On those days, I can’t fathom a more complicated way to interact with a patient chart and place orders. But then I remember the days in the not-so-distant-past that I spent valuable time chasing down a patients chart, or cringed at the sound of the cart full of paper charts heading toward my desk as I’m researching a patient’s medical history. And when I do, the amazement at how far we’ve come with health IT - and how far we have to go - returns and I remember why I am not only a doctor, but a physician-vendor.