The greater the impact technology has on patient care, the more critical it is for leaders to focus on the human element.
It may seem contradictory, but to people like Dirk Stanley, MD, who act as a bridge between the IT and clinical worlds, it makes perfect sense. And as automation continues to take on a larger role in healthcare, he believes it’s becoming increasingly vital for leaders to realize that “managing those things outside of the computer is so important for managing things inside the computer.”
During a recent Keynote, Stanley, who serves as CMIO at UConn Health, talked about the fine line leaders must walk in leveraging technology without leaning on it completely, and the tremendous potential AI offers – if approached carefully.
Dirk Stanley, MD
One of the biggest frustrations for users is when something doesn’t look right on the screen. And while the inclination is to blame technology – or the people who implemented it – the more effective route is to ask some critical questions, Stanley said. “Why is it not right? How did it get built into the screen? Who made that decision? How did they make that decision?” When teams are willing to have those discussions, it becomes evident how influential outside forces can be.
“You start to realize the computer is just a reflection of what people told it to do,” he noted.
“And so, if you’re not happy about the way it’s working, it’s because there's a human being who made a decision.” If a group of people made the decision, it’s important to inquire as to whether all of the right stakeholders were involved, because when all is said and done, it’s not just about technology. “It’s about how human beings interact. It’s about teamwork and governance,” along with policies, regulations, and so much more.
It comes down to a fundamental issue that has plagued the industry for years, particularly since the dawn of Meaningful Use: the “ocean of data” being presented to providers.
“Healthcare as a whole is still struggling to make sense with all the information we’re collecting, and there’s a lot of it,” Stanley said. “There are so many data points. So many data elements. When you structure documentation, there are so many things you can collect.”
And it isn’t just the data that goes into the medical record; it’s also the meta data in the patient’s chart. The prospect of pulling out all the useful and relevant data can be downright daunting. Further complicating matters, he added, is a tendency among some to emphasize data going in versus data going out, or vice versa.
“As an industry, we have to recognize that both branches are important, and you can't ignore one for the other,” said Stanley. “When I approach workflows, I start by talking about how we’re going to collect the information and how we’re going to analyze it. I think a mature way of approaching it is recognizing both of those at the same time. That helps you collect better data, retrieve better data, and analyze better data.”
Of course, any discussion on data is going to delve into artificial intelligence and how automation can ease various tasks for physicians, nurses, and other staff. And although Stanley certainly sees potential for GenAI when it comes to draft summaries of documentations and billing codes, he urged leaders to exercise caution when it comes to clinical conversations. “That can get messy, especially when you have people speaking different languages. Sometimes you have to even change your pattern of speech for people’s different educational needs, for example. It’s important to pick up on those nuances,” he said. “You still need a human being to sign off on that.”
Other areas that show promise include ambient listening and chart summarizations, which can be particularly impactful when sifting through 30 years of notes. “If you’re able to just ask a question or do a search, that’s a big opportunity for time savings,” not to mention more effective processes.
In order for that to happen, however, leaders need to ensure that the proper workflows are in place – a topic Stanley often writes about in his blog. The best way to determine that, once again, is by talking to those on the frontline about the current state – who does what and when, and what challenges need to be addressed.
In many cases, he noted, “a simple reordering of the sequence of events can have a massive change in usability, in satisfaction, and in outcomes.” And while technology can certainly play a role, actual people need to be involved as well.
“You almost need to take a human factors engineering approach to it. Because once you have the workflow, then you can say, what data elements do I need for this step? Where in the medical record are we going to store that information? How are we going to store it?’ That way, when you redesign it, the reporting works properly and people like the workflows.”
For Stanley, that’s as important as anything. “If you enjoy creating good user experiences, not just for doctors, but for nurses, pharmacists, and most importantly, for the patients, it’s so rewarding.”
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