A “secret shopper’s” perspectives on the EHR and clinical workflow

As someone who has practiced medicine using both paper and electronic records, and someone who’s been focused on the health tech scene for the past 20 years, you might think I’ve seen it all. Indeed, during my 35 year career in medicine and tech I’ve traveled the world and learned a lot about healthcare, clinical practice and the intersection between medicine and technology. However, there’s nothing like being a secret shopper to get a little reality check on where things stand with electronic health records and clinical workflow.

As someone who has practiced medicine using both paper and electronic records, and someone who’s been focused on the health tech scene for the past 20 years, you might think I’ve seen it all. Indeed, during my 35 year career in medicine and tech I’ve traveled the world and learned a lot about healthcare, clinical practice and the intersection between medicine and technology. However, there’s nothing like being a secret shopper to get a little reality check on where things stand with electronic health records and clinical workflow.

For the past couple of months, and likely continuing for most of the next year, I am charged with helping a family member through treatments for an all-too-common medical problem–cancer. That means I am accompanying my family member through diagnosis, surgery, chemotherapy, radiation therapy, and eventually medical monitoring and follow-up. Let me tell you, there’s nothing like being in the trenches of a patient care experience to see how far we’ve come, and how far we still need to go to fix healthcare.

The hospital and health system we are visiting uses one the major EHR solutions. However, even within the same institution, departments seem anything but connected. When we have multiple appointments on the same day in different departments, we are still filling out paper forms asking the same questions in every department we visit. Worse yet, even when we make our second or third visits to those departments we are again presented with forms to fill out. Wouldn’t it be better to fill out that information on a tablet device or kiosk and make it available to all departments at once? Wouldn’t it be better on subsequent visits for us simply to review the information on an electronic screen and edit or update it as needed? Where’s the single version of the truth?