How COVID-19 drove the need to make physicians' lives easier

MedAware CEO and cofounder Dr. Gidi Stein

Photo courtesy of MedAware

Electronic health record burnout is a global issue that, like everything else in healthcare, has been exacerbated by the COVID-19 pandemic.

The fundamental flaw for physicians from EHRs is not so much the death by 1,000 clicks that has been widely reported, but that EHRs were not built to help them perform better, according to Dr. Gidi Stein, CEO and cofounder of MedAware, based in Israel.

"It was physicians feeding the beast," Stein said.

Stein, who remains a practicing physician, remembers making rounds 20 years ago with a clipboard of two pieces of paper and writing prescriptions by hand, based on memorizing the available drugs. Now each patient has a chart the length of a phone book, and there are thousands of medications, he said.

The caseload has risen too, from seven or eight patients to up to 15. 

This was cause for burnout in normal times, Stein said.

"Obviously COVID made it much worse," he said.

The burnout impact of COVID-19 went beyond work overload to the tragedy of watching too many patients die from the virus.

But now, Stein said, "As we come out, physicians say, 'We've had enough. Give us something that will actually help us.'"

WHY THIS MATTERS

MedAware, founded in 2012, has developed a platform using AI and machine learning to cut down on the excessive medication alerts physicians receive. 

The software, embedded in the EHR, uses clinical knowledge and algorithms to identify potential medication-related errors, evolving adverse drug events and even opioid addiction.

But instead of the 20% of false positive alerts that represent "EHR noise," the platform flags about 1% that are sent to physicians and pharmacists. The alerts are integrated into physician and pharmacist workflow.

"If you add algorithms and AI and learn the behavioral pattern of physicians, and then alert only on situations that are extreme …," Stein said, this reduces alerts to about 1% of prescriptions. Of the alerts sent, about 80% are relevant and an estimated 40% change physician behavior. 

"We don't have alert fatigue," he said.

MedAware's alert platform produces ROI through reduced admissions and hospital stays. 

During the first wave of COVID-19, hospitals and physicians were too busy to hear about solutions. 

"Everyone went to the bunkers," Stein said. Company representatives were told, "'Don't talk to us,'" he said.

But as the first surge of COVID-19 receded and health systems lost a lot of money, providers began to look for solutions. 

"For strategic partnerships, it was a great year," Stein said. "These were companies able to understand the need and plan for the future. For us it was a great year."

By the second or third wave of COVID-19, health systems understood the real need of what their clinicians were facing and the resulting burnout, he said.

The company is currently concentrating on markets in Israel and the U.S., though it is exploring opportunities in other countries. It works mostly through partnerships, having their solution embedded in other solutions within the hospital workflow.

THE LARGER TREND

COVID-19 has spurred certain innovation, as providers rethink the delivery of healthcare to make it more equitable, and consider how to help clinicians to avoid future burnout and the resulting staff shortages.

Technology has saved lives that would have been lost 20 years ago, but Stein is attempting to combine what he calls a simpler time with new AI capabilities.

"Twenty years ago," Stein said, "there were maybe a few tired doctors and nurses standing around a patient's bed. Now they're all tired, staring at a computer. The bed is down the hall."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com