Primary care physicians should demand better technology for patient care

Primary care physicians should demand technology that serves as a benefit, not a barrier, to patient care, said the leader of a leading electronic health record (EHR) company.

Kyna Fong, PhD, co-founder and CEO of ElationHealth, spoke about technology, billing and the health care workforce in her keynote address at PC22. Primary Care for America, a collaboration devoted to promoting and sustaining primary care, held the two-day conference, held in person and online May 25 and 26.

ElationHealth EHR services now serve about 23,000 clinicians with more than 10 million patients around the country. The company is a founding partner in Primary Care for America.

“The topic that I was going to focus on is, where do we go from here? And what's the future of primary care?” Fong said. “And not to be not to be overly dramatic, but I do think we have an opportunity of a lifetime here, at least our lifetimes, to really take primary care to the next level and have a sustainable health care system that really is grounded in sustainable primary care.”

Fong recounted presenters and said the audience heard loud and clear the incentive system is broken for medicine in general. For primary care physicians, fee-for-service payments have led to the stereotype of a physician with a hand on the doorknob for the entirety of a visit because they only have a few minutes to spend with a patient, she said.

That has inspired doctors trying to be successful in valued-based care arrangements, Fong said. But value-based care has a challenging “underbelly” – administrative burden and overhead.

Larger health care organizations can hire staff and teams to do the requisite documentation, coding and additional clerical work. That becomes a challenge for smaller practices, especially when some of the work does not seem fully aligned with care, and a strain on the physicians in them, Fong said.

In health care, technology often is spoken about “as a barrier, as a limitation, as a creation of friction,” when it should help physicians, Fong said.

“And that is a tremendous opportunity,” she said. “We should have technology … that enables us to really achieve our goals, reduce repetitive work and allow high quality talent be able to focus on what it is they do best.”

EHRs parade as clinical systems and do have clinical modules, but really were built around billing and administrative needs. Now, software companies have built their business models around that, Fong said.

EHRs then become a “huge barrier” to moving away from fee-for-service payment and toward a value-based system because if the technology “just fights you every step of the way,” physicians lose cost savings and efficiency, Fong said.

Along with technology, Fong cited the panelists’ examples about fee-for-service payments and reinventing the primary care workforce through education, a cycle that will take time to break.

Fong discussed her family’s experience with the complexities of medical payment. She said her father was an “extremely passionate” primary care physician who moved their family to the United States because he could not practice personalized medicine that he wanted to in Canada.

“In conclusion, I think the future of primary care is incredibly bright,” Fong said. “I'm incredibly optimistic about it. And this last day and a half has only added fuel to that and I hope all of you will return to your respective organizations with a renewed passion, renewed energy, and acknowledge that this is a community, and a growing community, that really wants to see primary care thrive.”