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When Engaging Patients, Do We Give Them a Voice?

I took part in an interesting conversation today on Twitter about who EHR vendors are selling to at an organization.

For most organizations, the focus for selling has been centered on the CFO and CIO. This makes sense, of course―vendors need to center a sale on the person who has the power to say “yes.”

Even when KLAS recently brought in a new (non-HIT-related) piece of technology that I wanted to use, I worked with that company’s team to make sure we could present a strong case for the tool to our CFO. There’s an old saying about purse strings and power, and it’s not wrong.

The problem with this sales method is that we miss the voices of those people who will be impacted daily by the EHR. For a myriad of reasons, clinicians are suffering under the weight of an EHR productivity paradox. I can’t help but wonder whether that burden would be lighter if the clinicians could in the room before a contract is signed.

Thankfully, the argument for a clinically based CMIO is strong and has grown over the past decade. These leaders are often the perfect balance between understanding clinical workflows and IT restraints.

Take for example Dr. Milligan of Asante Health, who acted as a physician lead during the organization’s Epic implementation and now helps maximize usability for clinicians as the CMIO.

However, the comment that stuck with me the most in my twitter conversation was that of Erin Gilmer, a patient advocate. While the voice of the clinician in buying decisions is growing, the voice of the patient is all but nonexistent. My initial reaction to that sentiment was, “I don’t necessarily care what software my mechanic is using―I just want my car fixed. It’s the same for my healthcare!”

Patient Engagement

But as I stewed on the thought, I had to change my thinking a bit. When it comes to my mechanic’s technology, I don’t have to choose to use it at all. They use their OBD2 scanner and grab the codes from my car’s computer, and they chase those codes to find the root problem. Then, when approved, the mechanic replaces the necessary parts.

In healthcare, I inevitably have to interact with the EHR because I am not just the customer but the “car.” Somewhere down the line, be it through a patient portal or during the check-in process, I will have to interact with the system.

Perhaps this lack of a patient-centric focus group for healthcare IT is why patient-portal adoption is dismally low in real-world applications, or why one study found that the more physician attention an EHR consumes, the less satisfied the patient is.

I understand why the patient voice doesn’t get consideration at the table; for most patients, the healthcare system (and healthcare IT in particular) is an esoteric world. Every time I visit the doctor, I ask, “What do you think of your EHR?” I’ve found it to be a foolproof way to pull a clinician out the routine and have a genuine conversation.

That kind of response tells me it’s not very common for patients to ask about or even know about these multimillion-dollar systems.

On October 1st and 2nd, KLAS will be holding one of our annual conferences, and this one will be centered on patient engagement in particular. I’m excited to be a fly on the wall and watch as leaders from across the spectrum of healthcare discuss how to better engage patients. If the opportunity presents itself,

I may just advocate that the first step of patient engagement should be inviting them to become part of the conversation.