Physician Assistants Are Ideal Leaders for EHR Implementation (Part I)

As the U.S. moves towards the implementation of EHRs at its hospitals, private practices, and clinics, finding enough talent on the bench at EHR consultants and companies will become increasingly difficult. There are simply not a large number of people that have the experience to get all hospitals up on an EHR before the impending federal dis-incentives kick in. Hospital and healthcare organizations look to in-house talent for energetic and accomplished people to “staff the project.” 

Organizations usually look to nurses and some physicians to fill these roles on their teams. Finding the best people is imperative to project success. One place that makes both clinical and financial sense, but might not be first on the executives’ minds, is physician assistants (PAs.)

PAs are trained to practice medicine as a member of the physician-directed care team¹. There are approximately 75,000 PAs in current practice today. PAs act as an extension to the physician . They diagnose and treat patients and perform the functions most often thought of as physician-related jobs² . What many people don't know is that the PA often has the job of facilitator on their team. They provide the translational capabilities for both the doctors and nurses on their team because they fit into neither group but must work very closely with both. PAs (and other mid-level providers) get things done for the nurses and the doctors they work with. This get-it-done approach often leads to better outcomes and more satisfied patients³. For many PAs these skills translate to other areas of medical care delivery⁴.

In front of you lies a big translational project as you choose, design, build, and/or implement your EHR. A PA can fill the job of leader in this process.

Here’s my example: I work for an academic medical center. For the past 16 years, I have been practicing medicine in the clinic, the hospital wards, the ED, the OR, ICU, and at rehab facilities. Over this time I have worked for and with many physicians. I have served as a medical director for a family medicine office, served my state PA society in a variety of roles including as president, brought advanced surgical training programs to my medical school, taught medical/RN/NP/PA students in the classroom and at the bedside. I have managed staff nurses and physicians. Over this time I have served on committees as part of my job and professional activities. One of these interactions allowed me to be part of my healthcare organization’s EHR implementation.

From the earliest beginnings of my career I have participated in projects and studies using computers in the provision of care for patients. The logic behind using an automated system to couple medical knowledge to the practice of medicine is extremely enticing. How can a human remember all there is to know in medicine? How can they remember to order the right doses of drugs for the right durations? If we could automate some of the work couldn't we spend more time with the patients? The opportunity to participate and possibly influence the informatics of medicine seemed like a natural extension for the work I had been doing.

In the next part of this blog, I’ll explain why you might want to look to a PA for help with EHR planning and implementation.

Clinically a physician assistant in family medicine and now trauma and burn surgery, Peter Igneri now works for both in the Simulation Center at University of Vermont’s College of Medicine. He is also the former medical director of a family physician office, president of the PA Academy of Vermont, and sometimes consultant in the area of EHR and PA utilization.

 Coker, T. R., Chung, P. J., Cowgill, B. O., Chen, L. & Rodriguez, M. A. (2009). Low-income parents' views on the redesign of well-child care. Pediatrics. 2009 Jul;124(1):194-204

Hooker, R. S. (2000). The economic basis of physician assistant practice. Physician Assistant. 24, 51-66, 71

Laurant, M., Harmsen, M., Wollersheim, H., Grol, R., & Sibbald, B. The impact of Non-physician Clinicians: Do They improve the Quality and Cost-Effectiveness of Health Care Services? Medical Care Research and Review. 66(6), 36S-89S.

Nyberg, S.M., Waswick, W., Wynn, T., & Keuter, K. (2007). Midlevel providers in a Level1 trauma service: experience at Wesley Medical Center. Journal of Trauma. 63(1), 128-134
Coker, T. R., Chung, P. J., Cowgill, B. O., Chen, L. & Rodriguez, M. A. (2009). Low-income parents' views on the redesign of well-child care. Pediatrics. 2009 Jul;124(1):194-204