Content by Jeff Ball, chief growth officer, Lumeon.
It has been said that, to a hammer, every problem looks like a nail.
In healthcare IT, electronic patient records (EPR) systems have assumed the role of the hammer. And as more money is poured into such systems – £2 billion to digitise the NHS, including electronic patient records in all NHS trusts (hospitals or other healthcare providers) by March 2025 – the figurative hammer is growing larger.
However, the hammer is still just a hammer. EPRs may be a critical foundational technology in our health systems, but it’s time to acknowledge what they are and are not. EPRs are really quite passive information repositories, systems of record that catalogue patient data; they do not drive action. What’s needed are systems of action able to address the gargantuan workforce and care timeliness challenges health systems face today.
As staffing firm Michael Page notes, “A wave of burnout is affecting the understaffed NHS workforce, with close to 100,000 unfilled vacancies across the organisation.” Fewer people are entering the nursing profession at a time when the nursing workforce is ageing. Michael Page concludes: “With so many nurses close to retirement and not enough new recruits to plug the gap, nursing in the UK is likely to face a significant staff shortfall.”
All of which is to say: health providers must find innovative new ways to do more with less – specifically, provide more patient care with fewer clinicians available to deliver it. Or put another way, technology must be applied to streamline care team workflow to drive efficiency.
As was noted in HTN last week in an interview with a health IT executive, “With regards to improving efficiencies within hospital, poor patient flow not only risks harm to the patient, it also takes up a lot of staff time. Ultimately, from an efficiency point of view, staff time is money. Anything that enables the process to run more smoothly helps us spend more time with our patients rather than tackling logistical problems.”
So, what technology beyond (or layered on top of) the EPR is called for?
A system of action is focused on enabling an organisation to take action based on the information stored in its system of record and other data sources. It involves tools and processes that facilitate collaboration, communication, decision-making, automation, and task execution to achieve specific business objectives. And that’s where EPRs often fall short because they were never architected to do these things.
It’s all well and good for a clinician to go into the EPR to look up a patient’s test or lab result, or to order a prescription. Those are straightforward, individual tasks.
But the EPR wasn’t designed to support team-based care, which is at the heart of care delivery today, within and beyond the hospital. It doesn’t traverse different systems and technologies to pull together real-time data from various places and it doesn’t inherently help manage populations. For that you need a platform purpose built for care orchestration, one that complements the EPR and integrates with it to leverage the patient data that resides there.
Complementing EPRs with powerful intelligent automation, creating an agility layer that leverages current IT investments, is the path forward. Consider the impact across the entire clinical staff and hundreds of patients by putting all care coordination into orchestrated action with personalisation and precision – and for example, reducing the time spent charting pre-surgery assessments from 11 minutes to two minutes per patient case. Here is what automation brings to the table to address these EPR gaps while improving care delivery and outcomes.
Unburden the workforce from unnecessary tasks
It’s abundantly clear that praising our healthcare workers for “stepping up” and going “above and beyond” is not a solution – and it has taken a toll on the workforce and the care they deliver to patients. In addition to the demands of documentation, fragmentation further complicates orchestrating care across an organisation, requiring more handoffs and more follow ups, adding to the frustration felt by care teams.
Instead, we need to make their jobs easier, so they can focus on the work they are trained to do, leading to the best possible care outcomes and better experiences for the patients. There are many tasks that can be removed from daily workloads by automating them. For example, typically manual tasks in the pre-operative process, such as checking the patient’s record, gathering information from the patient, ordering labs, can be part of an automated process that adapts to the needs of each patient.
By automating manual tasks, activities, workflow and events, the technology burden for navigating and documenting care can be dramatically reduced. Rather than feeling constantly behind and overwhelmed, care teams participate in a more efficient, proactive process, where the technology within their workflows makes it easy to know what to do when for their patients, and eliminates time wasted chasing down details and following up with others.
Reduce costs and backlog by saving time and avoiding waste
While automating tasks reduces the burden on care teams, it also reduces the cost of care in ways EPRs alone can’t. Standardising care using best-practice protocols is one approach to reducing costly variations in care. However, most organisations find that because the pathways are static, they fail to achieve their potential impact.
For example, when a patient needs a routine procedure, such as a colonoscopy, there is a standard protocol to assure the patient arrives prepared and ready for care. Given that the EPR may not have all the latest information, current medications need to be confirmed with the patient, requiring manual review and follow up. It’s easy for things to get overlooked, such as a patient taking blood thinners not reflected in the EPR medication list. If the patient arrives, but the procedure can’t safely proceed, time and resources are wasted.
Through automation that works in conjunction with the EPR, the sequence of tasks for each patient adapts as needed without letting anything fall through the cracks. If the patient confirms current medications do not include blood thinners, no one needs to spend time following up. And, if the patient updates her medication list to include blood thinners, the appropriate care team member is alerted as the pathway adapts to new information. This way, the right steps can be taken proactively, so she can still arrive properly prepared for the procedure.
This level of clinical workflow automation increases efficiency and productivity while avoiding costly waste from last-minute reschedules and avoidable care delays. When taken at scale, efficient use of time and resources reduces costs and waiting lists across the hospital network.
The case for applying automation in this way seems intuitive. As was noted in HTN’s interview last week, “Every time you take delays out of [the care delivery] system, you drive efficiencies. You slightly relieve the pressure on incredibly hard-pressed staff, and you allow the entire organisation—the NHS and social care in its broadest possible definition—to work as efficiently and smoothly as possible.”
There’s no hammer on Earth that can accomplish that.
To learn more about real examples of care orchestration and clinical workflow automation in action talk to Lumeon here.