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Dr. David Asch

Q&A with Dr. David Asch, executive director of the Penn Medicine Center for Health Care Innovation

by Gus Iversen , Editor in Chief
From the January/February issue of DOTmed HealthCare Business News magazine

Penn Medicine has an ambitious new plan to transform EHRs into more streamlined, interactive, smarter tools that ease the work of clinicians, expedite care, and drive the best possible patient outcomes. By prioritizing the needs of providers, who are increasingly burdened by the demands of data entry, they are reimaging these tools as not merely documentation systems, but as an element of care delivery itself.

HealthCare Business News spoke to Dr. David Asch, executive director of the Penn Medicine Center for Health Care Innovation, to learn more about the initiative and its goals.

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HCB News: You and your team at Penn Medicine are setting out to improve the way physicians relate to the EHR. What can you tell us about your own background with health records and what led to this initiative?
Dr. David Asch: Most members of our team are clinicians, and that’s critical. But members of the team also have three other essential skills, including software development, design, and behavior change. And pretty much everyone has at least three of those four.

The clinical sensibilities are so critical because we are ultimately solving for the best patient outcomes. And often the best way to solve for patient outcomes is to develop tools that are effective for clinicians. If you are in the business of making scalpels, you want those scalpels to be useful to the surgeons who are operating on patients. If you are in the business of building electronic medical record systems, you want those systems to be useful to clinicians caring for patients.

Right now, the clinicians are complaining that contemporary EHRs are not so useful. We think they can get better with skills from clinical medicine, software development, design, and behavior change.

HCB News: It seems paradoxical that EHRs would present new challenges to workflow when we're so accustomed to technology making our lives simpler. Why are medical records an exception?
DA: Technology certainly has that opportunity to simplify – it comes down to what it was designed to accomplish. Early EHR development focused on meeting administrative standards for documentation and billing. The unrealized value still awaits as far as designing technology that can now also enable clinical care to be more frictionless, informed, and coordinated.

HCB News: To what extent are the problems with EHRs provider based, as opposed to vendor/software based?
DA: The answer is of course both, but I will take sides here for emphasis. The problem is vendor/software based. Yes, clinicians – like all humans – are reluctant to change. But better designed software would have been designed around them in the first place so they wouldn’t have to change much. There are close to a million physicians in the U.S. alone and just a handful of software vendors. Wouldn’t it make more sense to move the software rather than the physicians?
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