The problem with the medical problem list

Organization is everywhere these days, whether it’s targeted at getting your house, your finances, your job, or your life in order. So, it makes sense that there’s a need for organization within the medical field as well. What to tackle first? The medical problem list – an often-disorganized hub with an overwhelming amount of information – is a strong candidate for a revamp.
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Problem with the Problem List

Imagine a project with poor organization, technology issues, and lots of busy work. For most of us, it’s a situation that would be frustrating at best and at worst, could prevent the job from getting done. So, when these three headaches come together in healthcare, it’s easy to see why there’s cause for concern – and why there’s a problem with the problem list.

Think of a patient’s medical problem list like a Cliff’s notes for the clinician – it should be clear, easy to digest, and have all of the major and important points highlighted at the top. When it takes too long to read, is needlessly complex, or is so unorganized you’re reading it twice, it ceases to be a useful tool.

Listing off the problems

Unfortunately, that’s what’s happening to many clinicians when they begin a patient visit. What was once designed to be a clean, easy-to-read summary of a patient’s relevant diagnoses, lab results, imaging, and test results is more often than not a disorganized list containing outdated or irrelevant information, along with duplicate entries.

And this jumble of information has ripple effects throughout clinical workflows and the patient experience. Unorganized problem lists mean that physicians spend valuable face time with their patients hunting for the information they need, not providing the best care they can.

On top of that, poorly organized problem lists can’t provide the best clinical decision support possible, which waters down the power of our electronic health records (EHRs). Finally, the more cluttered the problem list gets, the more difficult it is to make sure all of a patient’s relevant information is documented accurately. It leaves clinicians choosing between a hefty increase in the amount of documentation they need to complete, or to a decline in the quality of that information.

If it sounds like the consequences are dire, it’s because they are. However, it’s a situation where the solution really is simple, and one in which common sense organization techniques – like streamlined ways to remove old, incorrect, or redundant information – can actually have a huge impact.

By addressing this straightforward, critical issue, health systems can start to address big issues like physician burnout and help clinicians avoid wasting valuable time on administrative tasks.  It’s a pursuit that is well worth the investment.

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