An Industry Call to Action: Why the EHR must fit how providers deliver care

In a recent physician survey, more than half of 17,236 respondents said that the EHR has reduced or detracted from the efficiency of their practice.

As Gary Price, MD, and Tim Norbeck pointed out  in Forbes, “…the current user interface of virtually every EMR in wide use today is a constant source of inefficiency, waste, and frustration in physician’s daily attempts to care for their patients… Once organized to succinctly focus on the key elements of a patient’s care, the record is now an unintelligible mass of data, organized only virtually around a priority of data reporting, billing, and regulatory checklists…A drastic overhaul of this interface to make it more efficient and user-friendly, leveraging current technology to actually make the point of care a more productive place to work is absolutely mandatory.”

So why are we so reluctant to directly address a major problem universally acknowledged to be negatively impacting our physicians and healthcare system?

At TransformativeMed we couldn’t agree more.

That’s why every CORE Value Suite app is  designed to  make the EHR work for providers, instead of the other way around. And, each app embeds directly into the Cerner EHR without interfaces.

How Dr. Brent Wisse Makes the EHR Fit His Glycemicare Workflow

Dr. Brent Wisse recognized early on that the cornerstone of effective inpatient glycemic control is an EHR that gives providers what they need when they need it.

In his own words: “Good glycemic management improves immune function, speeds wound healing and prevents fluid and electrolyte shifts. For hospitalized patients, it is a key part of quality care.

When I initially became involved in inpatient glycemic control, I thought I faced an educational issue. That was wrong. During educational programs, I learned that hospitalists and house staff mostly had the knowledge to deliver good glycemic care. They understood how to order and adjust basal and meal time insulin. Yet in practice, they just weren’t doing it.

When I looked closer, I discovered the real bottleneck: time. The critical data (blood sugar changes, meal timing and content, insulin doses given) providers needed to effectively optimize insulin dosing was scattered throughout the EHR, and they didn’t have the time in their clinical workflow to put it all together. On an average day, providers attended to dozens of urgent tasks per patient, and ran out of time to tackle glycemic control. Insulin doses didn’t get adjusted, and blood sugars stayed high.

The cornerstone of effective inpatient glycemic care is clinical workflow efficiency.

Glycemic data needs to be available in a form that providers can view and absorb, in under 30 seconds. Understand whether given insulin doses were too high or too low, and how to optimize insulin orders moving forward. An effective glycemic control support tool must be simple-to-use, and fully integrated into clinical workflow.

GlycemiCare instantly gives me the patient data and clinical decision support I need, when I need it, to help deliver glycemic care efficiently, effectively and consistently.

Since 2009, GlycemiCare has become the go-to tool for all of our glycemic control decisions at the University of Washington. In rounds, new providers regularly express their excitement about their improved workflow related to glycemic control. When residents graduate and move to other healthcare systems, I often get emails asking, “How can I get GlycemiCare here?”. Without GlycemiCare, they tell me that their ability to efficiently provide glycemic care for their patients has disappeared. That is the value that GlycemiCare provides.
Picture1.png

Associate Professor, Department of Medicine, Division of Metabolism, Endocrinology and Nutrition

Brent Wisse, MD