Ron Elfenbein, MD, CEO at emergency medicine clinic Chesapeake ERgent Care in Gambrills, Md., discusses the possibilities of computer usage beyond data storage and how it could benefit the future of EHRs and the healthcare industry.
Responses are lightly edited for clarity and length.
Question: How has your role as CEO evolved over the past two to three years? How have your responsibilities regarding the EHR and clinical decision support changed since you took on the role?
Dr. Ron Elfenbein: I now have a better understanding of the use of the EHR from a billing perspective, which is very helpful. From a clinical perspective, the EHRs are still the same as they always have been, except they are flashier now with more bells and whistles. They are helpful from a metrics standpoint as it is much easier to cull data, but it is unfortunate how lacking EHRs are in terms of integrating clinical decision support.
The EHR should embrace the 'power of the computer,' and help guide decision-making, not just serve as a warehouse for information. It should help physicians mitigate risk, make better and faster decisions, give them probabilities and likely outcomes based on available data and help to ultimately guide decision-making. It should also make recommendations for treatment modalities and tests to order as well as flag things to watch out for. As of now, EHRs don't incorporate those elements.
Q: Which apps and technologies do you find most helpful when it comes to clinical support tools?
RE: I frequently use Epocrates and VisualDx. I defer to Epocrates for medications, but VisualDx is by far the most helpful because it is the only medical decision support tool that actually aids in clinical decision-making.
Q: Where do you see the biggest need for innovation to improve the healthcare system in the future?
RE: The industry needs to embrace the actual power of the computer, instead of just using it as a data storage device. The current state of affairs regarding EHRs is simply to use them as fancy, data-storage mediums and providers as data entry technicians. The [National Security Agency] can sort through 50 million phone conversations and find the one concerning call in the entire world; credit card companies can sort through billions of transactions a day and find the one that is suspect — all in real time. Yet, unfortunately, the EMR cannot provide me any aid in my medical decision-making. We are using incredibly antiquated technology and not at all touching on the actual power of the computer, which is a real tragedy.
Q: How do you feel about the use of voice recognition technology, such as Amazon’s Alexa and Google Assistant, in healthcare? Is there a place for its use within the EHR?
RE: I absolutely think there is a place for it within the EHR. I currently use Dragon dictation— which makes my 'data entry,' a much easier and faster task. I think having some artificial intelligence integrated into the EHR that is responsive and voice activated is a given. The questions are: Who will design it first, and how will it work or be integrated? These systems have flashy colors and improve their interfaces, but to me, those upgrades really amount to little in terms of efficiency. It's the AI component that needs to be embraced as that is where the true power of the computer can be helpful in medicine. Voice activation is nice, but AI is where the future lies.
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