Anyone interested in the OpenVista Electronic Health Record, Medsphere’s commercial product (which, Dr. Kizer says, “is VistA at the core” and is being marketed to hospitals and large clinics) can learn more at www.medsphere.com.
Dr. Kizer says hospitalists will need to understand the needs of future healthcare and help prepare for and welcome it. “For example, performance measurement is an absolute part of the future of healthcare,” he says. “I think, by and large, hospitalists understand that better and are more accepting of that than certainly most docs in private practice.”
He believes hospitalists “can help promote that understanding among their peers and their hospitals and keep moving things forward as opposed to resisting it.” This is just one aspect of the “openness and transparency that we want to see in so many areas,” says Dr. Kizer, and hospitalists can be “pushing for the tools to make it happen. The hospitalists, I would think, should be leading the charge for electronic health records.”
Now and Tomorrow
Dr. Kizer, who is one of nine experts on veterans’ issues named to the newly formed Commission on the Future for America’s Veterans and is board certified in six medical specialties, also has a personal view on the work of hospital medicine. Recently, his wife was hospitalized in the ICU at the University of California at Davis Medical Center for a number of months, and Dr. Kizer says that a succession of hospitalists have served as her principal providers. It’s given him a more intimate view of what matters, beyond strictly clinical care, to patients and their families.
“By and large, I’ve always supported the hospitalist notion,” he says, “because it … supports my view [that] keeping up to date on all the science and technology and running an office practice [at the same time] is just more than you can reasonably expect anyone to do.” What he has especially noticed now, as a family caregiver visiting a hospital, “is that there is tremendous variability in how much [hospitalists] communicate with the patient and his or her family and how they view the episode of care within the context of the family and their community.”
Dr. Kizer, who has studied communications for a long time and in myriad ways, notes that a lot of the hospitalists he has met during this recent experience “think they’re communicating, but they often don’t take the time to determine if they are actually connecting with the family or addressing the issues that are important to the patient and family.”
In the same vein, he agrees that the better the electronic communication systems of a healthcare system—including proficiency in identifying medical errors—the more minutes can be freed up for a physician to pull up a chair and talk with a patient. “It is also a powerful tool to educate and to help inform,” he says. “For example, when [a hospitalist] can just quickly graph out where the patient’s blood pressure … or blood sugars or … creatinine has been, you can use the display of data to quickly educate the patient and/or the family about what has happened and where you need to go. One picture can save you 10 minutes of explaining.”
Conclusion
The VA has taken a lead in addressing the issues that have been brought up over the years by organizations such as the Institute of Medicine and the Institute for Healthcare Improvement. Their integrated electronic health records system can serve as a model for non-VA hospitals. Until there is a national integration of computerized technology, hospitalists can become advocates for improving their own hospital technology systems. “Electronic health records and hospitalists should go hand in glove,” concludes Dr. Kizer. “It’s potentially a great marriage of technology and the human element.” TH