Why does a culture of care need to precede EHR adoption?

Author Name Robert Green   |   Date October 8, 2013
The right person having access to the right information at the right time — it’s a key context for the EHR conversation with regard to workflow throughout the clinic. But more than filling in those blanks in the medical record before, during, and following the patient encounter, there is the context for all this information and these people: the culture of care. This context is the bridge that defines the relationships between the staff as much as it does with those people served by the clinic.

Perhaps another way to perceive the value of the culture of care is to think of achieving meaningful use of certified EHR technology serendipitously in the clinic. Beginning with the question among clinic staff, “What would it take to realize our own expectations for every patient experience?” It may sound like a question that’s already been asked, until you ask all those in the clinic for their answer.
Consider the comments from Martin A. Makary, MD, MPH, of Johns Hopkins University School of Medicine regarding his interpretation of the results of a study on the connections between patient satisfaction and the quality of surgical care:
The better the workplace culture for staff, the more satisfied the patients, Makary says. In any industry, if the employees feel good about their workplace, they are more likely to have satisfied customers. Doctors and nurses feel strongly that wide variations in teamwork culture are behind wide variations in quality, but there hasn’t been a lot of focus on culture in the past.
The interpretation of the “what” that describes health data for patients remains a cornerstone of the physician-patient interaction. No matter how much accessibility I have to my health data, I’m still not a physician and therefore lack the formal training and experience to appropriately interpret that information.
The “why” that adds context to that data, however, is something that I do have in my mind. The “why” represents my story that may not only help me understand my data in a more meaningful way personally but also help me (and perhaps my advocate) learn more about my journey ahead.
Given the opportunity within the receptive culture of the clinic to bring my story, there may therefore be a connection between the “what” and “why” of my experience that contributes to a more meaningful interaction with share accountability.
Long-term success with EHR adoption will be driven by the clarity and execution of the culture of care, regardless of the size of the clinic. Since the EHR Incentive Programs and meaningful use are really just a minimum set of performance expectations within the clinic, there is no reason to place the burden of the clinic culture on the EHR vendor.
There is a great deal of insight within every clinic that must define the context for the EHR and, even more, the shared expectations of “what” and “why” for every patient’s experience. It may have as much to do with patient and staff retention today as it does with preparing for a new level of accountable care tomorrow.