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Technology has become embedded in almost every part of healthcare, and the ways we rely on it to help deliver care will only continue to increase. The days of clipboards at the bedside are dwindling in favor of EHRs, handheld devices, clinical decision support, intelligent surgical tools and so much more.
With these innovations playing an increasing role in delivering care, they have an unavoidable influence on processes – and ultimately even culture – in a hospital. The way a software solution is designed and the workflows within it, for example, can shape a clinician’s decision-making, how or when they interact with colleagues or patients, or the steps they take to deliver care.
As technology becomes ingrained deeper into healthcare, providers must recognize how it impacts their work and care delivery decisions. Just as importantly, the companies that create healthcare technology need to understand the outsized responsibility that comes with the growing influence they have on a health system’s people and processes.
The shift towards placing more responsibility in the hands of tech vendors began with the HITECH Act in 2009. Dedicating $30 billion towards a massive nationwide initiative to mandate electronic health records laid the foundation for everything in healthcare to go digital. Since then, healthcare innovators have been racing to build on top of that foundation with venture capital investing in the space reaching a record high of nearly $60 billion in 2021.
Simply put, there’s no turning back from the digital transformation that’s underway and continuing to pick up steam. This is why it’s critical for the people who design and use healthcare technology to always consider the influence it can have. By the broad nature of Meaningful Use, we’ve already seen some of the unintended consequences technology can have on care delivery. For example, despite all the promise digital health records hold for the future of care, the barriers they’ve erected for patients and burnout they’ve caused providers are well-documented challenges.
However, with thoughtful and intentional design, development, and use, technology can ultimately have positive influences on process and culture. One example is how it can influence providers to meet the standard of care for glycemic management in the hospital. This is an issue that can too often be deprioritized by care teams, but an important one that has become much more prevalent based on new CMS measures that will encourage hospitals to begin reporting rates of hypo- and hyperglycemia at the beginning of next year.
One of the main challenges with managing blood glucose levels is that it’s rarely the primary reason for a patient’s hospital stay. It’s very natural for the initial cause of a hospital stay – whether it’s a heart condition, surgery, labor and delivery, or any other reason – to be the biggest concern of the team treating a patient. As such, blood glucose is something that is often overlooked despite the fact 2 in 5 patients admitted to the hospital have hyperglycemia and require their blood glucose to be actively managed.
This is a scenario where technology can help positively influence process and culture by thoughtfully designing features that can make it easier for providers to do the right thing, and harder to do the wrong thing. In this case, it means integrating seamlessly with EMRs in a way that forces providers to check a patient’s glucose levels. For patients who require insulin therapy, it can also steer providers away from manual dosing calculators in favor of more accurate and personalized recommendations.
I’m in a unique position to understand the influence of technology from two perspectives. I am a physician and hospitalist who is an end-user of various forms of healthcare technology, as well as a chief medical officer of a company that designs software for the hospital. This perspective allows me to offer several suggestions that ensure healthcare providers and technology vendors maintain partnerships focused on the ultimate goal of delivering better care.
For technology vendors, the first step is to always remember the influence you have and to consider it in every decision you make. Technologists can sometimes become laser focused on what they’re building, making it easy to lose sight of why they’re building it or the potential side effects or unintended consequences that might result.
It should also go without saying that clinical expertise is extremely important. You need to be tightly aligned with the people who will ultimately be using your product. If you don’t have current or former clinicians on staff – and even if you do – forming a customer advisory board can offer a formal means for invaluable feedback. Depending on the type of solution you’re creating, you may also have to seek data partnerships that will allow you to test your solution on real-world data. Ultimately, be sure to seek feedback from and spend time understanding the roles of every potential user of your software. For the technology to deliver the positive impact it is designed to have, it must fit into existing end-user workflows as seamlessly as possible.
For providers using new and constantly evolving technology, engaging with your technology providers to create open and honest dialog will help ensure that they design and revise solutions with your workflows and the utmost care for patient safety in mind. It’s unwieldy and impractical for every end user to be engaged with tech companies, and it could also cause issues inside your organization. Start by coordinating feedback and working through your IT team to be most effective and ensure compliance with your organizational policies.
Most importantly, as technology continues to progress in ways we don’t yet understand, the best thing for everyone in healthcare to do is stay vigilant – and this is especially true with artificial intelligence. We’re at the very beginning stages of exploring how AI can be applied in healthcare, but the options are endless, and it will certainly have a profound effect on how we deliver care in the future. But what won’t change is how important it is for the people creating and using the technology to always keep patient care and patient safety in mind.
Photo: Urupong, Getty Images
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