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Got Your Invisibility Cloak On?

April 26, 2013
by Mark Hagland
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Time to find out what your physicians are saying about their EHR experience
Mark Hagland, Editor-in-Chief of HCI

As I write this column, the news has just broken that scientists at the University of Texas-Austin have developed an “invisibility cloak”—something at least conceptually akin to the shroud that Harry Potter wore in “Harry Potter and the Deathly Hollows,” as he floated around the Hogwarts School and other places and spied on people and snuck into places where he wasn’t supposed to go.

As U.S. News and World Report’s article on the development ( noted, “The catch is that, for now at least, it only shields objects from microwave light.” But, the article notes, “The researchers are optimistic that they will someday be able to develop similar technology to hide an object from visible light.”

So…what might you use your “invisibility cloak” for, if you were given one? How about this—you could find out exactly what your organization’s end-users are saying about you when you’re not present (granted, it’s quite possible that many of your more outspoken end-users will be more than glad to tell you what they think of you, to your face). Or maybe even better, you could watch your physicians struggle with some of the more challenging aspects of your electronic health record (EHR) as they conduct office visits with their patients.

I can tell you that I’ve had very interesting conversations with my personal physician during my two most recent office visits. My physician, whom I’ll call Dr. Happy, was dragged about 15 months ago, kicking and screaming, into an EHR go-live, as the integrated health system that employs him implemented its first EHR system-wide. Dr. Happy was anything but delighted when I saw him in December 2011; and, knowing what I do for a living, he was more than happy to give me a big earful of complaints about the EHR they were just beginning to go live with back then. “Look at this!” he exclaimed, showing me a few specifics of the ordering and documentation elements in the system. “Who designed this stuff? Some college kid? Certainly not any clinician!”

Since then, Dr. Happy has gone through several of the Elisabeth Kubler-Ross famous “five stages of grief,” and, as of this spring, he had at least come to accept that EHRs are here to stay, and that he needs to use one—every day. So when, once we had concluded our physician-patient consultation, I engaged him in conversation about his health system’s EHR, he ushered me over to the screen of his portable workstation, and walked me through some of the ordering and documentation issues that he feels are hobbling his workflow. And, as he explained those problems, particularly around task-sequencing, I had to concede that he had/has some very legitimate complaints.

So the reality, it seems clear to me, is that, as we ask physicians to participate in the building of the new healthcare—a healthcare system with far greater patient safety, care quality, efficiency, cost-effectiveness, accountability, and transparency, and one that is focused around the concepts of population health and accountable care—we need to fix the problems inherent in virtually all of today’s EHRs, so that physicians at the very least won’t feel workflow-hobbled. We’ll be discussing such issues at the Healthcare Informatics Executive Summit in mid-May (please see our website for details), and I can’t wait to engage there in in-depth discussions with industry thought-leaders.

But in the meantime, what’s clear to me is that you won’t need to wait until scientists can provide you with a Harry Potter-style invisibility cloak to learn what physicians need, in return for their participation in the drive towards the new healthcare. Just ask them—they’ll tell you.