Do VA Hospitals Need More Doctors or Do More Doctors Simply Need Better IT?
By Dr. Donald Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.
A board-certified anesthesiologist, researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.
He can be reached at donald.voltz@gmail.com or twitter–Donald M Voltz, MD @donald_m_voltz
Thanh Tran, CEO of Zoeticx, Inc. also contributed.
The VA scandal has led to calls for more doctors and nurses to be hired to help alleviate an influx of veterans from the wars in Afghanistan and Iraq, as well as the long-term care of aging vets from Vietnam at its network of 150 veteran hospitals. The department is trying to fill 400 vacancies to add to its roster of 5,100 primary care doctors.
In addition, the US faces a shortage of more than 90,000 physicians by the end of the decade, according to the Association of American Medical Colleges (AAMC) and 60,000 as early as 2015. Meanwhile, there are current shortages of physicians in rural and underserved urban areas. This is despite the number of first-time enrollees in US medical schools at an all-time high of 20,055.
While hiring more doctors would certainly help prevent looming shortages, another solution, perhaps longer term, is for VA doctors to better utilize their time by seeing more patients and spending more time than the industry average of eight minutes per patient. A key component to every visit is checking the patient’s medical records, and doctors are finding they are wasting valuable patient time by using disparate, and difficult to use EMRs.
$2.05 Trillion Spent on EMRs, But no Solution
The Healthcare Information and Management Systems Society (HIMSS) notes that approximately $2.05 trillion is spent on EMR systems yearly. However, a study of 1,000 physicians by the MPI Group found that nearly 70% of physicians say the current electronic health record (EHR) systems have not been worth it. While some physicians do cite EMR benefits, most physicians do not believe the current systems create new efficiencies, share data with multiple providers or improve patient care, criticizing the usability and interconnectedness of current EHR systems.
One respondent noted that his office “used to see 32 patients a day with one tech, and now we struggle to see 24 patients a day with four techs. And we provide worse care”. Another noted that “the failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place”.
“Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction,” the report found.
Bridging the Data Gap
What the VA needs now is technology that works the way medical professionals work. A system to align medical professionals with data that needs to be collaborative, not passive, and include analysis. The right data also needs to be delivered to those who need it, when they need it, with all the data in one place.