The Best EHR for Functional Medicine Docs Who Are Done With Burnout

What I’m going to show you is the very best EHR for functional medicine. What would it look like? An unbelievably great 1-hour patient visit. When the patient first comes in, they finally feel heard. The documentation works. It includes labs, supplements, protocols for alternative medicine approaches to things as well as traditional follow-up tasks. All the systems built together, multiple screens that you can work with at home, at night, your family can go to bed at a normal time as so can you. Um, it builds your credibility, makes you look like you know what you’re doing. Perception is everything. You may be a great doctor, but if patients don’t perceive it, they’re not going to know you’re a great doctor. I’m Dr. Jay, the founder of Espri Health. I’ve had 30 plus years in functional medicine um and have built systems for functional medicine and have discovered that practitioners aren’t the one who are broken. It’s the architecture of the HR that was designed for billing that’s broken. Today, we’ll cover why documentation follows you home like a sick dog. is no fun. Horrible, right? And the top five architectural requirements for a functional medicine EHR. Um, I’m going to show you why really good docs who go the aspree way will reclaim 10, 20, 30 hours a week and can use it any way they want. Um, and what software looks like when it really works the way that your brain works when you’ve been trained to do really good medicine. Number one, the patient visit isn’t the work that drives you crazy. It’s the work after the patient leaves. That’s that paperwork. That’s that administrative stuff. Um during the visit, it’s great. Um you listen to the patient a little bit and you do your work. If you’re working with the spree, you’ll build trust. You’ll gather the story. You’ll look at all the different elements of health, sleep, stress, nutrition, medications, supplements, prior treatments. If you wait until after the visit to do the documentation, it’s really hard to recognize patterns and treatment plan and everything, if you do it in the visit, it changes everything. Um, the reality for most people now is that their 1-hour visit with a patient because it’s so disjointed and it’s so oriented towards billing and compliance that that 1-hour visit gives them a little bit of insight, but they’re going to have an hour or two of additional work. uh at pajama time at home. The family’s sleeping, their house is quiet, they’re still working, uh sitting at the kitchen table finishing notes, blogging and texting about how bad their life is because their EHR is the worst thing in the world and they hate it and they’re so burned out. Um the lie is that, you know, more documentation equals better care equals better pay. You get more money. Um so the more complexity that you’ve can document the more value your your visits have. Um and we can use the example of most EHRs that have you’re going from screen to screen to screen to click to click to click to to to actually create that that reality that this is hard and complicated so pay me more. No, we didn’t become health professionals to be data entry clerks. the unbelievable emotional cost and frustration and the things you miss. It’s it’s not worth it. And all of it is to support that unpleasant reality that you’re trying to justify billing. You’re not doing a a job primarily for the patients wellness because of the HR. Certainly, your mind’s there. So, functional medicine is not primary care with longer appointments. It’s an entirely different model and you need to transition. The big idea is that the patient’s story is like a symphony. There’s so many parts to it and if you can listen to it, it’s beautiful and it really, really works. So, how did we get so screwy and with functional medicine, you know, why didn’t we go down that path originally with the EHR? Um, because that whole transaction focused thing was the government insurance companies. Functional medicine on the other hand is relationship based and you have to know the patient in order to really make good decisions, be trusted and build that long-term health building plan, right? Um in the traditional EHR, um you’re going to ask a question. Um okay, where’s the lab? And you find the lab page and you look it up and you see the PSA and you’re like, that’s high. Um I wonder what the CRP is doing, the C reactive protein. I wonder what that’s doing because maybe it’s inflammation that’s causing the PSA to elevate. I only find that you say CRP and you find the CRP. You go, hm, I wonder what they were like on different days. It’s a lot of screening. With a good functional medicine software like a spree, you can graph that. You say, you know, I’m going to see the PSAs, CRPs of this patient for the last five years, and you can see it. And here they are tracking together. Oh, you know what? That looks inflammatory, not cancerous. How about that? So you can make those decisions based on really good data. And what happens is that EHRs that are built the old school way are not going to give you that kind of help. They’re not going to integrate lab together like that. You’re going to be screen to screen to screen. And with the patient story, you’re going to get the CRP and the PSA and say, hm, this is one sound. This it’s a minor note. The CRP in my symphony. This is a minor note and I’m gonna play this out and make sure that we treat that inflation and follow it to the resolution of that sound. Right? The symphony can be played with good software. You can’t do that with an incoherent architecture that doesn’t support you. So what you do instead is you work around. Right? Doctors are amazing workarounders. You’re in the ER and the patient has a problem and they have this piece of metal stuck in their leg and you don’t have the proper tool. So, you go to the maintenance department and you find a huge pliers and you clean everything up and you get the pliers and you work around and you make it work, right? That’s what we were trained to do. You make the make the changes you need to make to make it work. And doctors have done that with EHRs forever and it’s a shame that they’re so good at working around because they’ll put up with ridiculous EHRs because of it. Traditional HRs handle meds and they don’t do supplements, compounds, specialy labs, or any of that. They don’t. They have to add all that as an add-on. And because of that, you have this incredible Frankenstein monster of technology. You have all these different parts and pieces that you’re having to try to piece together. And uh I don’t know if you know Frankenstein eventually turned on his builder. So that’s that’s kind of the story, right? So notes are in one system, labs in another, supplements are somewhere else. You have all these different things and messaging. Who knows when it was done or where it was done? you have, right? You have the additional problem of just the brain drain of trying to figure out how to put that all together. Your staff’s mad. Um, everybody’s fatigued. Workarounds are great when you have to do it. But when it comes to an EHR, get an EHR that actually works with you. Okay? There’s five non-negotiables. Every EHR does appointments, right? Functional medicine requires a lot more. It has to show trends. What happens to labs over time? What happens to vitals over time? What about the total health score? Right? Meaning their quality of life. What’s happening with their quality of life? Is that quality of life improving? Because conventional medicine generally has that as a afterthought. With functional medicine, that’s an incredible data point. It’s so important. It’s very difficult for a patient who’s improving quality of life wise and to be getting sick at the same sicker at the same time. Right? We need to have some way to look at that. You can ask the patient, ask them how are you compared to how you were five years ago or two two months ago. They establish a new normal. So they really can’t tell but they you can tell the quality of life by a health score as spree provides that right. How about laboratory integration? A good system has to import the labs and interpret the lab and communicate the lab to you. Final interpretation belongs to you, right? new role new rules and laws. That lab gets reported to the patient within depending on which state you’re you’re in, 24 to 48 hours, you better have a way to get that lab evaluated really quickly and communicate to that patient really quickly because a blood sugar of 135 to some patient means they’re dying of diabetes. Well, they weren’t fasting. That’s a normal blood sugar. It’s okay. Hey, Bob, it’s okay. Your blood sugar is normal. Or they really have a bad cancer result. their biopsy result was positive for malignancy. You see that? Hey Bob, let’s schedule a call this afternoon at 3 o’clock and have the phone call and have the discussion or have them come in. Right? That’s important that those things are integrated, right? Protocol-driven treatment plans have to be included and they have to be able to be customized easily, reused intelligently and quickly all from one screen, not screen click click click all over the world. Um, and you don’t need to rebuild it from scratch every time, right? If you’re doing that, you got a bad system. Patient engagement should include from the beginning a dynamite questionnaire that gives you all of the information you need to start with that patient knowing their story really well and go for refinement. And your EHR should be an education and communication platform. That’s what it should do. It shouldn’t just be a documentation desk for you or a file cabinet for you. That’s not nearly enough. The patient now is expecting interaction, right? They have AI. They know. They know how to get answers. Why don’t they get them from you, right? Is the patient actively participating? If they’re not, get rid of it. Intelligent documentation. Point five. Should organize intake, identify patterns, present insights. So, you don’t have to do all the heavy lifting. It shouldn’t be the final word, but to have to come up with the the same answer every time, you should get help. Why not? So to ask your question, is the software doing any of the heavy lifting? Okay, if it’s missing one feature that you really, really need, you’re probably going to be doing some workarounds. If it’s missing a bunch, Frankenstein, that’s not going to be good. So when you do the demo, ask the vendors, show me your intake and workflow. Show me how the treatment works. Do you actually have a way to extract the patient’s story and show me some way that you can provide an easier way for me to get to the answers? Um, how many screens and clicks does it take to go from high to buy? What what does a good workflow actually look like? Um, a good workflow to me looks like the patient completes your software, organizes the data, software does it for you. It interprets, gives you the insights. Um, and I walk in um, totally prepared because the software has handed me the story and I can walk in and say, “What else would you like to tell me here?” It looks to me like these things are going what? I can listen and think. I can connect the dots and I’m not turned away from the patient. I’m not disengaged. Um I’m not really concerned about anything except my relationship and understanding the patient’s story. Um and I can use my clinical intuition, right? I can smell it out, feel it out, understand it. Um because none of us want to be the data entry sherpa, right? We want to be health professionals. So during the visit, you can do all of the necessary work. You can prescribe supplements, compounds, review lab, discuss quality of life, discuss plans, put it all on a note, sign it, send it, delivered, done. No duplicate entry, no hunting for information, no multiple systems. You close the chart, you leave the room, and you’re done. It’s pretty great. You can go deep with interpretation during that visit together with a patient. Go through your your thought process. Frequently patients look at me when I’m thinking and they say, “Is there anything wrong?” I said, “No, this is what it looks like when I’m thinking. You might not recognize it, but I’m actually thinking.” Um AI supports your judgment. It doesn’t replace it, right? Um, and the AI that we use, it’s a a real sophisticated algorithm. Um, it really presents all that you need to start and from there you can really go deep. Um, so to reclaim your practice, it’s it’s not about software. It’s about your life. It’s about what you’re going to get back from time, energy, mental energy, your family dinners. Um, and to do a really good job with patients. I mean, you should be doing functional medicine. That’s what I think. That’s the best I think it’s the best we can do right now. integrative medicine some people call it but functional medicine um so you have to listen and think you have to recognize patterns you have to build relationships um and and bad systems they don’t do any of that stuff they’re data entry systems right and they lead to frustration and burnout and as we get more sophisticated as AI has a greater role in the care that we’re providing your intuition your connection your trust your deep relationship with patients are going to make all the difference in the world can never generate trust it may generate answers We’re drowning in content, but we’re dying for connection, right? Great systems create better care, communication, outcomes, quality of life, and they resolve trust problems because the patient watches you work. They see your commitment. They see what you’re doing. Um, and the bad systems don’t do any of this stuff. The practitioners who are succeeding, they’re not superheroes. They’ve just got great EHRs and a great heart to really do a good job. And it’s much easier when your architecture supports you. So instead of asking the question, which I see all the time on blogs and feeds, it’s like, am I cut out for this? I I think I’m I’m thinking about resigning. Um, ask the question, could better software be the salvation of my career? I warrant that for several of our customers in Esprē, it has been. they were going to retire and it’s been years since that discussion and they haven’t. So yeah, functional medicine requires a completely different EMR architecture. Better architecture creates better care and better care creates a better life for everyone who’s involved. So if this was helpful, subscribe, watch the next episode and I’ll see you next time.