Peter Ehrnstrom, a 48-year-old dermatologist … says it’s typical for smaller physician-owned practices to lose 50% of their productivity while they get up to speed on their new EHR [Electronic Health Records] systems. Ehrnstrom says it takes him longer to type notes than to dash them off by hand. “If you add literally one minute per patient to my work, you’ve added 40 minutes to my day,” he says. “If you add five minutes per patient, you have now certainly just hit me with a 20 to 30 percent productivity loss. Charles Cutler, an internist in Norristown, Pa., has done similar back-of-the-envelope calculations. “I don’t think we’re going to come out on the other side of this endeavor financially better than the old system of maintaining paper records,” he says. This Machine Saves Lives so why Don’t More Hospitals Use it? Bloomberg Businessweek, July 1, 2012.
The IT department or Quality initiative or process improvement team would have us add some “simple” addition to what we do all day. IT would require additional logins or passwords or need us to add a step to unzip an email attachment before reading it. Quality wanted us to record some data or to add a check into the process and take a note or keep a record on what we did.
Minutes Really Do Matter
These folks just never seem to get it. I use to describe to them my day as a manager as doing some 500 one minute activities (e.g., take a phone call, respond to an e-mail, update a status, look up a piece of information, etc.). Every time they added a new step to my process, trying to improve things in some nebulous and unproven way, they added seconds and minutes to each one of those activities. Their reaction to this notion, that those extra steps significantly reduced my productivity was met with an incredulous “You must be kidding! That little change doesn’t take any time at all! You’re just a whiner ….” The clueless were calling me clueless!
My productivity or my team’s productivity in the day would drop. It was no back of the envelope calculation. I kept track of such things as how many emails were incoming and how many I responded to, how many defects we reviewed in a meeting and I could see when an added step cut our productivity in half for example. I would show these folks these kind of numbers and they would look confused. “No, no, it shouldn’t do that, you must be doing something wrong. No one else has data like this.” Since they had no idea of what daily productivity looked like, they had no way to assess the impact of the “simple” changes they wanted everyone to do.
Automation Isn’t A Magic Elixir
I personally love automating activities. If I can get a computer or device to do something for me, I’ll work around the clock and through the weekends to set it up. This was true even if I could do the same activity in a few hours or even minutes, manually, and be done with it. This time investment always paid dividends in the future when I had to do that activity again.
For more see One Way Not To Undervalue Yourself
However, a lot of automation (electronic records are a good example) can actually slow things down, if we don’t pay attention to how we do it. Just having a screen with the ability to type stuff into it or pull up stuff we or others already typed in doesn’t automatically increase productivity or accuracy.
The phrase “garbage in, garbage out” has been a well understood concept for a long time. We too often assume that things must get better if we “automate” it when this is often both unproven, and more to the point, not done well. I always remember the extorting to “put up a web site and all your marketing problems will just disappear!” It takes a lot more than just, for example, creating electronic records and imagining how it should just make things better, to actually improve the way anyone does business.
It Has To Be Actually Better, Duh!
I had been doing my personal finances using spreadsheets I had developed. It was a process that worked fine for me and I had a good overview of my finances and how things were going.
Just for the heck of it, I tried out this software package called “Quicken.” Wow. I was blown away. It was actually easier and faster to do what I was doing with Quicken than updating my spreadsheets. (Note, this was Quicken from the early 1990s, I still like Quicken, but it is now more of a challenge to use). This was an example of a package that was well thought out and tested and it really did make it easier to do these things.
The same was true when I used my first integrated software development environment (this was UCSD Pascal, again in the last century). Wow. It was just quicker and faster in a very intuitive way than the old text editor and compiler routine. I didn’t realize I could be so much more productive until I used this tool.
I’ve found that mobile phone apps (Android, IPhone) these days have a lot of these characteristics when done well. They make it extremely easy (maybe too easy from a security standpoint) to do things that take significantly longer on a PC web page.
So, don’t get caught up in the hype that electronic records or other kind of automation will magically fix anything. If it is not done well, such as just stuffing things on a computer (or putting it in a phone App) then it won’t help and in fact can significantly decrease our productivity and accuracy. Just make sure that shiny new tool really improves things before putting it into practice.
Is your project really implementing a proven and more productive approach or is it just implementing hype and speculation?