WEBVTT
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When we talk about modern medicine, what do we really mean?
00:00:07.759 --> 00:00:09.919
We've definitely solved a lot of problems.
00:00:10.160 --> 00:00:15.359
We can diagnose diseases that our former professors and mentors could never have done.
00:00:15.679 --> 00:00:20.800
We now treat conditions that were severely debilitated or even fatal just a few decades ago.
00:00:21.039 --> 00:00:24.079
We can send images across the country in seconds.
00:00:24.399 --> 00:00:25.679
Shall I go on?
00:00:26.000 --> 00:00:29.280
And yet, we have those moments.
00:00:29.600 --> 00:00:41.439
Take for example, when that critical piece of patient information, you know, a specialist note or discharge summary or a medication change, sits on a computer or server somewhere completely unused.
00:00:41.840 --> 00:00:51.119
Meanwhile, a patient sits in a waiting room, the staff unprepared, because that information never found its way to the person who needed to act upon it.
00:00:51.359 --> 00:00:57.200
Now ask yourself, how productive will that patient appointment be when they come to the office?
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Hello again.
00:01:02.079 --> 00:01:03.439
Welcome back to our podcast.
00:01:03.520 --> 00:01:03.920
I'm Dr.
00:01:04.000 --> 00:01:08.719
Kevin Hallow, surgeon, co-founder, and chief medical officer of Clinician Corps.
00:01:08.959 --> 00:01:15.120
On today's podcast, I want to reflect upon the importance of having the right tools for the right workflow.
00:01:15.359 --> 00:01:19.359
You see, we have communication tools that surgeons could not have imagined 20 years ago.
00:01:19.519 --> 00:01:27.359
Yet, despite this fact, having the right tools is not necessarily the same as having the right workflow.
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Let's talk about the difference.
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From my conversation with independent physicians, one consistent theme emerges: frustration.
00:01:40.879 --> 00:01:49.920
My colleagues are frustrated with a system where you can do everything correctly, yet the system still fails the patients that were trying to help.
00:01:50.239 --> 00:01:51.840
Physician clinicians have it all.
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They have electronic healthcare records, they have hybrid chart to connect to those EHRs, they have personal cell phones and the ability to text, they have emails, they have patient portals.
00:02:02.079 --> 00:02:10.319
Some have multiple referral platforms, each one requiring a separate login, each one competing for attention.
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They even still have fax machines.
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The problem that no one discussed it is that all of these doctors and the clinicians and the non-clinical professionals who work with them are swimming.
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Well, treading water, really.
00:02:25.120 --> 00:02:28.719
There are plenty of systems, but then you have to check them all.
00:02:28.960 --> 00:02:32.560
Some physicians can be managing five different systems at once.
00:02:33.039 --> 00:02:51.439
Each time a message comes into one of those systems that do not necessarily communicate with the other, the physician and their staff are gambling that it will surface before the next patient appointment, before something gets missed, or before a patient suffers a consequence for which nobody planned.
00:02:51.840 --> 00:02:55.280
The cost of that isn't just frustration, it's time.
00:02:55.439 --> 00:02:58.639
And in modern medicine, time is extremely valuable.
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How much time are we talking about?
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A practice administrator that I know actually calculated it.
00:03:05.120 --> 00:03:14.960
Her team spent an average of four hours a day reconciling information that technically already existed somewhere in their system.
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That's 20 hours a week spent on solving a problem that should not exist.
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It turns out that the information does not lack channels through which it can travel, it lacks a workflow path to get it to the person who actually needs to see it and act upon it.
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So, why does this fragmentation exist?
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I don't think that it was intentional.
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The systems were created with the best of intent.
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However, this problem is almost invisible to the people who designed these current systems.
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EHR vendors built messaging into their EHRs, referral platforms built referral systems, imaging centers built portals.
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Every company solved their own piece of the problem brilliantly.
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Each system works.
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Many work well.
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They work really well independently.
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But instead of being an orchestra, there are a group of musicians, each playing different instruments, each playing a different score.
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For example, the cardiologist can message his patient portal, the imaging center can upload results, the surgeon's office can receive facts.
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Yes, we still use facts.
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And they can file that fax.
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Every channel performs as designed, yet the information, and more importantly, the appropriate context for that information did not reach the right person at the right moment when it mattered.
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Okay, so we have the technology.
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The technology works as design, so the information and context are missing.
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What's the deal with that?
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Well, as it turns out, what we're missing is the intentional workflow design.
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The question isn't whether we can send a message.
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The question is when that message arrives, will it interrupt the person who can act upon it in a time for them to act upon it in a way that fits how they actually work?
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Most of our tools assume someone will notice, someone will check the inbox, someone will remember this came in and prioritize it.
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That's not workflow.
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That's hope disguised as a system.
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As a physician, we can get a lot of credit.
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That's nice.
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We like accolades.
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We can also get a lot of blame.
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That's not so great.
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Call it a hazard of the profession.
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But the blame is also spread around to our staff and even to the patients.
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So let's take a moment and try to imagine this from the patient's perspective and see if we can see where the breakdown occurs.
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More often than not, it's not anyone's personal fault, but a product of the system and the technology that we use to care for patients.
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Take as an example the patient in rural Nevada.
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There are many who need a specialist opinion.
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That's not unusual.
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What is unusual is the logistics.
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They likely will have to wait a long time, maybe months, to even get an appointment once the referral is sent.
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And after that wait, then they have to drive from Ely or Tonopah or Austin or Battle Mountain.
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Three hours or more for a consultation.
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All this time they're waiting for their care, plagued with the issue that requires a specialist input in the first place.
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Ironically, all of this could have happened over a secure message if that secure message had actually reached the specialist workflow in a timely and coordinated fashion.
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Now, think about discharge coordination.
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A patient leaves a hospital in Reno and goes back to their home in Earrington.
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The discharge note documents everything perfectly.
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In theory, the patient's primary care should be prepared, assuming that they see the note.
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But the note is buried somewhere, maybe in the patient portal, maybe in the hospital's EMR system.
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If the physician or their staff do not see it, then there is no continuity of care.
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Three weeks later, when the patient shows up in their primary physician's office or calls with a question about medication, the primary care physician and his staff are operating in the dark on outdated information.
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There was communication.
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It did happen.
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It just did not happen inside the workflow of the person who actually needed it.
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So neither physician nor the patient see that fragmentation per se.
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They just see the results of the fragmentation, the delays, the unproductive appointments, and the time spent managing the health system instead of their own health.
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Then comes the blame game.
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You know, my doctor never sent the referral.
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The hot that hospitalist probably forgot to dictate a note.
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The cardiologist or the dermatologist never called me.
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Well, you know, that patient forgot to get their records and imaging.
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We blame everything and everyone except the real problem, the lack of a proper workflow.
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That's just more broken logic that probably got us here in the first place.
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In 2022, the Joint Commission reviewed over 1,400 reportable never events.
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We all know what those are.
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In a large portion of these cases, the incidents trace back to the same core problem.
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Information existed, but it did not reach the physician or clinician who needed to act upon it in time.
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It was not a lack of knowledge, it was not a lack of competence, it was a communication failure.
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And it was not a freak occurrence.
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It demonstrates a pattern.
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Along that same line, researchers also documented a similar pattern with specialist consultations.
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Many specialist referral loops never fully close.
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The patient sees the specialist, the specialist writes a note, yet the referring physician never receives the consultant's findings.
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It is documented and exists, but simply does not make the journey back to the physician or clinician who started the process in the first place.
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The end result is duplication, delays, and sometimes patient harm.
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This is why the CDC and the Office of National Coordinator released their updated safer guidelines in 2025-2026.
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In that release, they did not name communication tools as a safety priority.
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They named reliable electronic communication inside clinical workflow as a patient safety imperative.
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The difference between those two things is everything.
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So how do we solve this issue?
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Well, it's not by adding another communication channel that operates independently.
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You solve it by creating a real clinical workflow.
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A structured workflow allows the primary physician and their staff to frame the information correctly.
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It ensures that the information is routed appropriately, quickly, and efficiently.
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It's not buried in a general message queue or competing with discharge summaries or scattered amongst patient portal messages.
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Physicians can receive the information where they're already working, creating actionable guidance and ensuring completion before the patient leaves the office.
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The same principle applies to coordination with labs, imaging centers, ambitious surgery centers, and more.
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These are not just contacts in a directory, they're participants in a shared clinical workflow.
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The relationship between a practice and its clinical partner should be built with defined roles, access, and expectations for what happens next and communication that lives inside that structure instead of beside it?
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It's not a new tool.
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That's a workflow pathway for the information to take to the right recipient at the right time.
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This brings me to something I think we should be asking ourselves.
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Do the tools that we already use actually put you inside the workflow, or are you just stitching them together in order to make them function?
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This is an important distinction.
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As a physician or clinician, every hour that you spend reconciling information is an hour you're not doing what you trained to do.
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And that is a source of burnout.
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When administrative burden becomes the largest piece of your day, and when a substantial portion of that burden is solving a communication problem that shouldn't exist, something breaks.
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And that something is you.
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As the administrator, how many hours is your team spending reconciling information that technically already exists?
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I'm serious about that question.
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Calculate it.
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Find out how much of your operational budget is going to solve a problem that a better workflow would prevent.
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Then imagine what you could do with that time and money if you actually had it.
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As a healthcare organization, is your communication with independent physicians built into a shared workflow?
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Or is it one more inbox competing for their attention?
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If you're a hospital system trying to strengthen relationships with independent physicians, fragmented communication isn't going to do it.
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The bottom line: reliable, structured communication inside a workflow that respects a physician time is the real holy grail.
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At the beginning of this podcast, I mentioned that clinical information sometimes sits on a computer or server while a patient is waiting in the waiting room or an exam room.
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I know that.
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Because I've been both the person with the information and the person waiting for it.
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As a surgeon, too often I've walked into the exam room and presented my standard greeting.
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Hi, Dr.
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Hallow, how can I help you today?
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Only to be answered by, I don't know.
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Or I have no idea why my doctor even sent me here.
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Then comes my what I call the detective shuffle.
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As I searched for information that never reached me or try to call a colleague for more input, only to get a voicemail.
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The frustration that I have felt is not from lacking communication capability.
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It's about having too much fragmentation to move with the speed and precision that I need to move to care for the patients.
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We know how to fix this.
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We have the technology.
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We have the regulatory guides.
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ONC safer guidelines, spell it right out.
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What we're missing is intentional workflow design and the decision to build communication into what and how we work instead of beside it somewhere.
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That's our podcast for today.
00:14:15.279 --> 00:14:17.519
Take a moment to reflect on today's topic.
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In your practice, what's actually happening when clinical information arrives?
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Is it reaching the right person at the right moment when it matters most for the patient?
00:14:27.200 --> 00:14:30.799
Or is it simply lost in another inbox that's already too full?
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That is a difference that matters.
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I'm Dr.
00:14:34.000 --> 00:14:37.519
Kevin Hallow, co-founder and chief medical officer of Clinician Core.
00:14:37.600 --> 00:14:52.240
To learn more about this topic and how our HCO Practice HQ and HC Console Core move clinical information inside a True Workflow that you can act upon, visit cliniciancore.com slash communication dash workflow.
00:14:52.559 --> 00:15:06.240
Thanks for listening to
00:00:04.480 --> 00:00:07.519
When we talk about modern medicine, what do we really mean?
00:00:07.759 --> 00:00:09.919
We've definitely solved a lot of problems.
00:00:10.160 --> 00:00:15.359
We can diagnose diseases that our former professors and mentors could never have done.
00:00:15.679 --> 00:00:20.800
We now treat conditions that were severely debilitated or even fatal just a few decades ago.
00:00:21.039 --> 00:00:24.079
We can send images across the country in seconds.
00:00:24.399 --> 00:00:25.679
Shall I go on?
00:00:26.000 --> 00:00:29.280
And yet, we have those moments.
00:00:29.600 --> 00:00:41.439
Take for example, when that critical piece of patient information, you know, a specialist note or discharge summary or a medication change, sits on a computer or server somewhere completely unused.
00:00:41.840 --> 00:00:51.119
Meanwhile, a patient sits in a waiting room, the staff unprepared, because that information never found its way to the person who needed to act upon it.
00:00:51.359 --> 00:00:57.200
Now ask yourself, how productive will that patient appointment be when they come to the office?
00:01:01.039 --> 00:01:01.920
Hello again.
00:01:02.079 --> 00:01:03.439
Welcome back to our podcast.
00:01:03.520 --> 00:01:03.920
I'm Dr.
00:01:04.000 --> 00:01:08.719
Kevin Hallow, surgeon, co-founder, and chief medical officer of Clinician Corps.
00:01:08.959 --> 00:01:15.120
On today's podcast, I want to reflect upon the importance of having the right tools for the right workflow.
00:01:15.359 --> 00:01:19.359
You see, we have communication tools that surgeons could not have imagined 20 years ago.
00:01:19.519 --> 00:01:27.359
Yet, despite this fact, having the right tools is not necessarily the same as having the right workflow.
00:01:27.599 --> 00:01:29.439
Let's talk about the difference.
00:01:33.920 --> 00:01:40.640
From my conversation with independent physicians, one consistent theme emerges: frustration.
00:01:40.879 --> 00:01:49.920
My colleagues are frustrated with a system where you can do everything correctly, yet the system still fails the patients that were trying to help.
00:01:50.239 --> 00:01:51.840
Physician clinicians have it all.
00:01:51.920 --> 00:02:01.439
They have electronic healthcare records, they have hybrid chart to connect to those EHRs, they have personal cell phones and the ability to text, they have emails, they have patient portals.
00:02:02.079 --> 00:02:10.319
Some have multiple referral platforms, each one requiring a separate login, each one competing for attention.
00:02:10.560 --> 00:02:13.120
They even still have fax machines.
00:02:13.439 --> 00:02:21.840
The problem that no one discussed it is that all of these doctors and the clinicians and the non-clinical professionals who work with them are swimming.
00:02:22.080 --> 00:02:24.719
Well, treading water, really.
00:02:25.120 --> 00:02:28.719
There are plenty of systems, but then you have to check them all.
00:02:28.960 --> 00:02:32.560
Some physicians can be managing five different systems at once.
00:02:33.039 --> 00:02:51.439
Each time a message comes into one of those systems that do not necessarily communicate with the other, the physician and their staff are gambling that it will surface before the next patient appointment, before something gets missed, or before a patient suffers a consequence for which nobody planned.
00:02:51.840 --> 00:02:55.280
The cost of that isn't just frustration, it's time.
00:02:55.439 --> 00:02:58.639
And in modern medicine, time is extremely valuable.
00:02:58.800 --> 00:03:00.800
How much time are we talking about?
00:03:01.360 --> 00:03:05.039
A practice administrator that I know actually calculated it.
00:03:05.120 --> 00:03:14.960
Her team spent an average of four hours a day reconciling information that technically already existed somewhere in their system.
00:03:15.199 --> 00:03:21.199
That's 20 hours a week spent on solving a problem that should not exist.
00:03:22.319 --> 00:03:33.120
It turns out that the information does not lack channels through which it can travel, it lacks a workflow path to get it to the person who actually needs to see it and act upon it.
00:03:36.000 --> 00:03:39.199
So, why does this fragmentation exist?
00:03:40.240 --> 00:03:42.240
I don't think that it was intentional.
00:03:42.400 --> 00:03:44.719
The systems were created with the best of intent.
00:03:44.800 --> 00:03:50.479
However, this problem is almost invisible to the people who designed these current systems.
00:03:50.800 --> 00:03:58.719
EHR vendors built messaging into their EHRs, referral platforms built referral systems, imaging centers built portals.
00:03:59.199 --> 00:04:02.719
Every company solved their own piece of the problem brilliantly.
00:04:02.879 --> 00:04:04.159
Each system works.
00:04:04.560 --> 00:04:05.680
Many work well.
00:04:06.240 --> 00:04:08.639
They work really well independently.
00:04:08.879 --> 00:04:14.960
But instead of being an orchestra, there are a group of musicians, each playing different instruments, each playing a different score.
00:04:15.360 --> 00:04:25.519
For example, the cardiologist can message his patient portal, the imaging center can upload results, the surgeon's office can receive facts.
00:04:26.000 --> 00:04:28.399
Yes, we still use facts.
00:04:28.720 --> 00:04:30.879
And they can file that fax.
00:04:31.360 --> 00:04:44.160
Every channel performs as designed, yet the information, and more importantly, the appropriate context for that information did not reach the right person at the right moment when it mattered.
00:04:45.279 --> 00:04:47.519
Okay, so we have the technology.
00:04:47.680 --> 00:04:51.279
The technology works as design, so the information and context are missing.
00:04:51.439 --> 00:04:52.720
What's the deal with that?
00:04:52.959 --> 00:04:58.319
Well, as it turns out, what we're missing is the intentional workflow design.
00:04:58.560 --> 00:05:00.879
The question isn't whether we can send a message.
00:05:00.959 --> 00:05:10.879
The question is when that message arrives, will it interrupt the person who can act upon it in a time for them to act upon it in a way that fits how they actually work?
00:05:11.519 --> 00:05:19.680
Most of our tools assume someone will notice, someone will check the inbox, someone will remember this came in and prioritize it.
00:05:20.240 --> 00:05:22.560
That's not workflow.
00:05:22.720 --> 00:05:25.680
That's hope disguised as a system.
00:05:28.399 --> 00:05:30.879
As a physician, we can get a lot of credit.
00:05:31.120 --> 00:05:31.839
That's nice.
00:05:32.000 --> 00:05:33.199
We like accolades.
00:05:33.759 --> 00:05:35.600
We can also get a lot of blame.
00:05:36.160 --> 00:05:37.360
That's not so great.
00:05:37.600 --> 00:05:39.680
Call it a hazard of the profession.
00:05:40.240 --> 00:05:44.800
But the blame is also spread around to our staff and even to the patients.
00:05:45.439 --> 00:05:51.839
So let's take a moment and try to imagine this from the patient's perspective and see if we can see where the breakdown occurs.
00:05:52.160 --> 00:05:59.519
More often than not, it's not anyone's personal fault, but a product of the system and the technology that we use to care for patients.
00:06:00.160 --> 00:06:02.800
Take as an example the patient in rural Nevada.
00:06:03.120 --> 00:06:06.879
There are many who need a specialist opinion.
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That's not unusual.
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What is unusual is the logistics.
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They likely will have to wait a long time, maybe months, to even get an appointment once the referral is sent.
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And after that wait, then they have to drive from Ely or Tonopah or Austin or Battle Mountain.
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Three hours or more for a consultation.
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All this time they're waiting for their care, plagued with the issue that requires a specialist input in the first place.
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Ironically, all of this could have happened over a secure message if that secure message had actually reached the specialist workflow in a timely and coordinated fashion.
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Now, think about discharge coordination.
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A patient leaves a hospital in Reno and goes back to their home in Earrington.
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The discharge note documents everything perfectly.
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In theory, the patient's primary care should be prepared, assuming that they see the note.
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But the note is buried somewhere, maybe in the patient portal, maybe in the hospital's EMR system.
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If the physician or their staff do not see it, then there is no continuity of care.
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Three weeks later, when the patient shows up in their primary physician's office or calls with a question about medication, the primary care physician and his staff are operating in the dark on outdated information.
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There was communication.
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It did happen.
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It just did not happen inside the workflow of the person who actually needed it.
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So neither physician nor the patient see that fragmentation per se.
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They just see the results of the fragmentation, the delays, the unproductive appointments, and the time spent managing the health system instead of their own health.
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Then comes the blame game.
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You know, my doctor never sent the referral.
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The hot that hospitalist probably forgot to dictate a note.
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The cardiologist or the dermatologist never called me.
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Well, you know, that patient forgot to get their records and imaging.
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We blame everything and everyone except the real problem, the lack of a proper workflow.
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That's just more broken logic that probably got us here in the first place.
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In 2022, the Joint Commission reviewed over 1,400 reportable never events.
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We all know what those are.
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In a large portion of these cases, the incidents trace back to the same core problem.
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Information existed, but it did not reach the physician or clinician who needed to act upon it in time.
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It was not a lack of knowledge, it was not a lack of competence, it was a communication failure.
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And it was not a freak occurrence.
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It demonstrates a pattern.
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Along that same line, researchers also documented a similar pattern with specialist consultations.
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Many specialist referral loops never fully close.
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The patient sees the specialist, the specialist writes a note, yet the referring physician never receives the consultant's findings.
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It is documented and exists, but simply does not make the journey back to the physician or clinician who started the process in the first place.
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The end result is duplication, delays, and sometimes patient harm.
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This is why the CDC and the Office of National Coordinator released their updated safer guidelines in 2025-2026.
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In that release, they did not name communication tools as a safety priority.
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They named reliable electronic communication inside clinical workflow as a patient safety imperative.
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The difference between those two things is everything.
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So how do we solve this issue?
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Well, it's not by adding another communication channel that operates independently.
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You solve it by creating a real clinical workflow.
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A structured workflow allows the primary physician and their staff to frame the information correctly.
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It ensures that the information is routed appropriately, quickly, and efficiently.
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It's not buried in a general message queue or competing with discharge summaries or scattered amongst patient portal messages.
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Physicians can receive the information where they're already working, creating actionable guidance and ensuring completion before the patient leaves the office.
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The same principle applies to coordination with labs, imaging centers, ambitious surgery centers, and more.
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These are not just contacts in a directory, they're participants in a shared clinical workflow.
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The relationship between a practice and its clinical partner should be built with defined roles, access, and expectations for what happens next and communication that lives inside that structure instead of beside it?
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It's not a new tool.
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That's a workflow pathway for the information to take to the right recipient at the right time.
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This brings me to something I think we should be asking ourselves.
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Do the tools that we already use actually put you inside the workflow, or are you just stitching them together in order to make them function?
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This is an important distinction.
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As a physician or clinician, every hour that you spend reconciling information is an hour you're not doing what you trained to do.
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And that is a source of burnout.
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When administrative burden becomes the largest piece of your day, and when a substantial portion of that burden is solving a communication problem that shouldn't exist, something breaks.
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And that something is you.
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As the administrator, how many hours is your team spending reconciling information that technically already exists?
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I'm serious about that question.
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Calculate it.
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Find out how much of your operational budget is going to solve a problem that a better workflow would prevent.
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Then imagine what you could do with that time and money if you actually had it.
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As a healthcare organization, is your communication with independent physicians built into a shared workflow?
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Or is it one more inbox competing for their attention?
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If you're a hospital system trying to strengthen relationships with independent physicians, fragmented communication isn't going to do it.
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The bottom line: reliable, structured communication inside a workflow that respects a physician time is the real holy grail.
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At the beginning of this podcast, I mentioned that clinical information sometimes sits on a computer or server while a patient is waiting in the waiting room or an exam room.
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I know that.
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Because I've been both the person with the information and the person waiting for it.
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As a surgeon, too often I've walked into the exam room and presented my standard greeting.
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Hi, Dr.
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Hallow, how can I help you today?
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Only to be answered by, I don't know.
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Or I have no idea why my doctor even sent me here.
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Then comes my what I call the detective shuffle.
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As I searched for information that never reached me or try to call a colleague for more input, only to get a voicemail.
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The frustration that I have felt is not from lacking communication capability.
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It's about having too much fragmentation to move with the speed and precision that I need to move to care for the patients.
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We know how to fix this.
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We have the technology.
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We have the regulatory guides.
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ONC safer guidelines, spell it right out.
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What we're missing is intentional workflow design and the decision to build communication into what and how we work instead of beside it somewhere.
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That's our podcast for today.
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Take a moment to reflect on today's topic.
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In your practice, what's actually happening when clinical information arrives?
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Is it reaching the right person at the right moment when it matters most for the patient?
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Or is it simply lost in another inbox that's already too full?
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That is a difference that matters.
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I'm Dr.
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Kevin Hallow, co-founder and chief medical officer of Clinician Core.
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To learn more about this topic and how our HCO Practice HQ and HC Console Core move clinical information inside a True Workflow that you can act upon, visit cliniciancore.com slash communication dash workflow.
00:14:52.559 --> 00:15:06.240
Thanks for listening to
