Q&A
Administrative burdens and technological solutions for H+H physicians
1:09:20
ยท
5 min
Council Member Schulman inquires about administrative burdens faced by H+H physicians and potential technological solutions. Dr. Katz discusses the challenges and ongoing efforts to address them.
- Administrative tasks have significantly increased over the years, including medication reconciliation and diagnosis management
- H+H is exploring AI and other technological solutions to ease the burden on physicians
- Efforts are being made to involve patients more in their care through patient portals and self-reporting tools
Lynn C. Schulman
1:09:20
What kind of, so the docs, like, what do they have a ton of paperwork to do?
1:09:25
Do they I mean, is there ways to alleviate that or, you know, I I I know I mean, I was there a long a while back, but in terms of AI, in terms of digital, in terms of anything that could be helpful to their experience.
Mitch Katz
1:09:41
Well, I think there's a lot that we can do.
1:09:45
You know, 30 years ago as a primary care doctor, a common note on a follow-up patient would be no triangle.
1:09:51
Sign my name, and the triangle being no change.
1:09:55
Right?
1:09:55
That's not an acceptable model anymore.
1:09:58
And now I open a record, and I have, like everyone who's seen the person in the last 3 months, I have to reconcile their medicines.
1:10:06
I have to reconcile their diagnoses.
1:10:09
I mean, it's a completely and and it's on me.
1:10:12
The specialists feel, well, I I I saw them for their heart.
1:10:15
I wrote the nice heart note.
1:10:17
Right?
1:10:18
Whether that heart note then conflicts with everybody else's note.
1:10:21
That's my job to fix.
1:10:23
Or the patients, you know, who I see on they they come to me for their 3 month follow-up, and they're on multiple nonsteroidal anti inflammatories because people keep adding them and no one tells them it's all the same.
1:10:36
So all you're doing is poisoning your kidney if you're taking Ibuprofen, and you're taking Naproxen, and you're taking, you know, a third one.
1:10:43
But but how's the patient supposed to know?
1:10:45
They're different medicines.
1:10:47
That falls that falls to us.
1:10:49
So, I mean, I think trying you're on the right track, or at least this is how I feel.
1:10:55
The answer can't be primary care doctors seeing fewer people.
1:10:58
The answer has to be making it easier for primary care pay people to see patients without burning out.
1:11:06
And I think it's changing expectations.
1:11:09
I think it's AI.
1:11:11
I think it's making it more a team sport.
1:11:15
It's making the patients we've had some you know, we use my chart.
1:11:19
And the happiest moment, and this often happens, I'm reconciling my medicines, and I see the patient, him or herself, has put in not taking.
1:11:29
I love that.
1:11:30
Right?
1:11:31
That's the person who should be putting in not taking it.
1:11:34
Right?
1:11:34
Because they right?
1:11:36
We wanna reach a point where patients look at their own records, you know, and object.
1:11:41
I love it also when patients object to their diagnosis.
1:11:44
You know?
1:11:44
And as soon as they object, I take it off.
1:11:46
Right?
1:11:48
Oh, yes, people will object to their diagnoses.
1:11:51
And on my chart, you can.
1:11:53
You can write, no, I don't think I have this.
1:11:56
You can write, I'm not on this medicine.
1:11:59
But that's where this needs to evolve.
1:12:02
Right.
1:12:02
And people say, well, you know, our patients, you know, are not tech savvy.
1:12:06
That's not true.
1:12:07
Our patients all have a smartphone.
1:12:11
There are language challenges.
1:12:13
You know, Epic has not been as great as I would like them to be about other languages.
1:12:18
Mhmm.
1:12:18
Like, we have full translation on the computer version
Mercedes Narcisse
1:12:22
Mhmm.
Mitch Katz
1:12:22
Of Epic.
1:12:23
So everything in Spanish on the computer version, not on the phone version yet.
1:12:28
So Okay.
1:12:29
You know, there's there's there's work to do.
1:12:32
You know, it's not it's not Epic has to do that.
1:12:34
It's not us.
1:12:35
Right?
1:12:36
But they're you know, again, 30 years ago, there would have been no computer.
1:12:40
10 years ago, nothing would have been in Spanish.
Dr. Rona Ray
1:12:42
Right.
Mitch Katz
1:12:43
Right?
1:12:43
I mean, it's the world is moving, but these are the directions.
1:12:46
We have to make it possible for people to meet the moment.
Lynn C. Schulman
1:12:51
No.
1:12:51
Absolutely.
1:12:51
And I, you know, I wanna thank you for making sure that you can get the insurance companies to, approve the medications, because, I happen to have a physician that really pushed, like, way beyond It did.
Mitch Katz
1:13:09
Yes.
1:13:09
See, that's what I mean.
1:13:10
It's mostly an obstacle.
1:13:11
It's assuming that you won't be able to find a physician who's willing to do that, even though it's the right thing.
1:13:18
Because, of course, there's no reimbursement for that.
1:13:21
Your doctor did that because your doctor, he or she, is a good doctor, not because they got paid for that.
Lynn C. Schulman
1:13:26
And in fact, I actually I went somewhere and the doctor didn't follow-up with the insurance company.
1:13:33
I went to another physician who did, and I got the medication.
Mitch Katz
1:13:46
All that means is they decide appropriate documentation.
Lynn C. Schulman
1:13:49
Yeah.
1:13:49
I've gotten that.
Mitch Katz
1:13:50
All that means is they decided that what the doctor wanted to use was not appropriate.
1:13:55
Your doctor did submit appropriate documentation.
1:13:59
They just decided that they didn't like the reason.
1:14:01
So but how how again, how the patient comes to you, and I've had the my my insurance company says that you didn't put down the right thing.
1:14:09
It's like, well, I put down what was honestly true.
1:14:13
Right?
1:14:13
I mean, I can't make up diagnoses.
1:14:15
Right?
1:14:16
I can't say you have diabetes if you don't have diabetes.
1:14:19
Right?
1:14:19
I mean, I can't do that.
1:14:21
But I can push, and I do, and I know our doctors do.
1:14:26
And that is one of the ways that our doctors are different and why time causes more a crunch than in in a make money, FIFA service, you know, churn people through, just get the dollars.
1:14:40
That's not my doctors.