Earlier this month, my practice converted from the Allscripts Professional PM and EHR system to athenaOne. If you have been through this process, you know it is not easy. Many have come to tears or left their job when going through a system conversion because of the stress of balancing seeing patients while learning a new system. While lessons were learned and there were hiccups along the way, our process went smoothly with only a 3-week ramp-up period.

The New England Journal of Medicine recently published a paper titled “Digital Minimalism - an Rx for Clinician Burnout.” The article points to a recent study that found the amount of time spent in electronic health records (EHRs) correlates with declines in face-to-face time with the patient, computer-based work after hours and increasing rates of burnout. Digital minimalism could be a new way forward for physicians.

Quality measures are a key aspect of primary care, not just because value-based care requires satisfaction to receive incentive payments, but because they can impact patient wellness. At a base level, it is common sense to evaluate an individual for early signs of diseases that could evolve into a more serious issue such as cancer or heart disease. Unfortunately, not all insurance payors have the same idea of what quality measures should be tracked or even what the target values should be. For example, one payor may say hypertension is defined as having a blood pressure of greater than 130/80 while another may say 140/90. Uncontrolled diabetes may be defined as an A1C greater than 8 for one payor and greater than 9 for another. A lack of consistency in these expectations causes confusion for primary care practices and can result in unmet quality measures.

It seems everywhere you look now, self-service is present from self-check-outs to ordering and paying using a QR code at a restaurant. Self-service, or the digital front door, became even more prominent with the COVID pandemic to reduce face-to-face interactions and the spread of the virus. Healthcare has had self-service options for patients for some time now through patient portals but these options are continually expanding to allow patients to interact with their healthcare team in the way they prefer. These methods can include self-scheduling, text messages to request an appointment or change an existing appointment, paying bills, completing health assessments before arriving at the office, and checking in for an appointment prior to arrival.

Staffing, access, and burnout are like four-letter words in most healthcare settings these days. There aren’t enough people to perform the tasks needed to keep patients flowing through the system or enough providers entering the industry to keep up with the demand resulting in limited access for patients in need of care.

Data in healthcare is now essentially ubiquitous: there are mountains of it everywhere. With the promise of tech and big data, healthcare systems snapped up technology that promised to capture all their data and provide enhanced and unprecedented insights. EHRs were pushed on physicians, claiming better data collection, organization, and utilization.

As a company working towards a value-based care program, the number one thing needed for success is the alignment of your incentives with each of your team members. 

While it’s nearly impossible to attribute just one, or even a handful of causes to the lack of traction or success for value-based care, it is possible to assess influence and recommend focused avenues for positive change.