Electronic Health Records: Bhoyrul’s Approach

Introduction

Health care institutions continue to concentrate on timely and high-quality care delivery, adopting recent technology solutions and embracing evidence-based practices. For instance, electronic health records (EHR) enable sharing of information about a patient’s condition and care between various providers and medical institutions. Undoubtedly, IT solutions improve quality of care, organizational efficiency, and convenience, reduce errors typically seen in hybrid systems, and give hospitals access to financial incentives (Entzeridou et al., 2018). However, Bhoyrul expresses his concern about excessive digitalization that threatens medicine’s real meaning and makes it lifeless (TED, 2014, 3:56). According to him, the data is useless when there is no connection between patients and doctors. Further in his talk, the bariatric surgeon introduces his EHR approach and the concept “of time in.” Although constant digital improvement of health care is crucial, providers should not lose their humanity and empathy.

Main body

The concept of “time in” on the job was derived from the “time out” approach in operating rooms. This safety checklist helps the surgical team ensure that the patient, location, tools, medications, and surgeons are right. In general, it reduces the possibility of error by incorporating the additional tool for monitoring the process. However, time-outs say nothing regarding a person who sleeps under an anesthetic, while EHR promotes personalized but indifferent care delivery. Surgeons may know everything about the issue, have a clever treatment plan at their disposal but know nothing about a particular patient and his/her goals. For that reason, Bhoyrul introduced a “time in” activity that delivers personal information to the medical team (TED, 2014, 7:37). He asks the person who knows the patient the best to provide the speech on why the latter is here, what she/he strives for, and other elements of the personal background. It supplements the lifeless digital age care making it more human-centric and additionally motivating the staff to put more effort.

This attribute addresses the issue of more mechanistic health care delivery promoted by current regulations and policies. In my organization, nurses and other clinicians are encouraged to be open to patients, consider their needs, and respect their choices. However, when put into practice, especially in high demand for care, there is an evident lack of empathy due to an inferior connection between the patient and provider. It reserves room for situations, as one mentioned by Bhoyrul when a patient sued the hospital despite being saved from death (TED, 2014, 1:50). The high pressure from regulatory bodies to improve health care quality contributes to the reduced humanistic element of the job. For that reason, the new EHR (Excellence, Humanity, and Respect) seems to be a great way to address the growing issue. Caregivers should go beyond the current EHR, form a human connection by listening, looking, and touching the patients (TED, 2014, 4:53). It is essential to connect data to particular individuals and find out why they are here. Only then the mutual respect between caregivers and patients can be achieved.

To my mind, it is contradictory to expect healthcare professionals to deliver personalized care in a climate of intense compliance issues. The Affordable Care Act (ACA) implementation led to a significant increase in insured Americans and initiated delivery system reforms. It put additional pressure on nurses and physicians to provide higher quality healthcare services to almost everyone in the US. Although all regulations and related guides endorse personalized care, it is impossible to achieve this level of personalized care in practice. The laws such as HITECH Act promote the meaningful use of EHR and general improvements in care. The collected personal data helps providers identify appropriate treatment and make it more personalized than ever before (Entzeridou et al., 2018). Nevertheless, new EHR systems were found to double clinicians’ cognitive workload due to complex interfaces (Leventhal, 2021). It means that they spend more time, including off-duty hours, adding patient data to the system. Thus, current approaches focused on cost reduction and health outcomes improvements find providers out of time to deliver support or establish a connection with a patient.

However, practitioners should incorporate at least a “time in” approach despite the time constraints and limited resources. The speaker’s example does not require much effort but provides valuable insights regarding the patient’s situation (TED, 2014, 7:37). The similar activities adopted by different specialists will result in breathing life into EHR and improving personalized care delivery. This approach may also help them redefine and stick to their own reasons to become health care practitioners. It is essential to realize that care is more than the mechanistic activity of analyzing symptoms and providing treatment.

Conclusion

To conclude, the idea of a new EHR presented by Bhoyrul can be helpful in health care settings to improve provider-patient connection. It also may result in better health outcomes for the patient since clinicians deliver highly personalized care. Although different regulations and laws put additional pressure on the providers, the “time in” approach does not require much effort and resources; thus, it can be implemented. I agree with the speaker that health care in a digital world should not be limited to dealing with EHR data. In order to improve therapeutical relationships with the health care users, nurses and physicians should connect data to individuals to provide adequate and humanistic treatment.

References

Entzeridou, E., Markopoulou, E., & Mollaki, V. (2018). Public and physician’s expectations and ethical concerns about electronic health records: Benefits outweigh risks except for information security. International Journal of Medical Informatics, 110(1), 98-107. Web.

Leventhal, R. (2021). Study: Adopting new EHR system doubled clinicians’ cognitive workloads. Healthcare Innovation. Web.

TED. (2014). EHR: The inflection point of medicine/ Sunil Bhoyrul [Video]. YouTube. Web.

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StudyCorgi. 2023. "Electronic Health Records: Bhoyrul’s Approach." February 20, 2023. https://studycorgi.com/electronic-health-records-bhoyruls-approach/.

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