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In our practice we have developed a team based model of care, where the nurses take an active role in prevention, chronic illness care, care coordination and documentation. We are hampered in our efforts by limitations in our EHR(McKesson) and constraints of policy, both of which are often designed for the old paradigm in which the sole important interaction is between the doctor and the patient, or perhaps more perversely in recent times, the doctor and the computer.
From technology we need 1. a team log-in 2. better longitudinal records 3. improved usability.
From policy makers we need evidenced-based policies around security, signatures and order entry.
For example, my team and I spend several hours each day on wasteful workflows. A task that should be doable on one screen… more »
While each of these may seem individually trivial, they add up to hours of wasted effort each day, increase professional burnout and are a threat to clinical quality. « less