10 Questions: Elizabeth Madigan, PhD, RN

https://goo.gl/NXio4G

1. What's the biggest barrier to practicing medicine today?

In the U.S., we still have a system that makes care coordination difficult. Almost everyone has a story about an older friend or relative who sees multiple providers, but, for example, there is no communication between that patient's cardiologist and rheumatologist. The electronic health record has helped [when] the providers are in the same healthcare system. Across healthcare systems, we are not there yet.

I come from the home healthcare world. In that setting, we routinely may be unable to access electronic healthcare information for all the systems through which a patient receives care. As a result, home healthcare nurses cannot easily and seamlessly share their observations with other providers. We're making progress on this front, and I am optimistic that this barrier will be greatly reduced in the next five years.

2. What's the most important healthcare issue that nobody is talking about?

The aging of the healthcare provider workforce. Throughout the nursing community, we are well aware of the growing nursing shortage. For nurses, but also physicians, physical therapists, and other disciplines, the retirement projections are scary. With the aging of the American population and the growth in chronic non-communicable diseases, we will need more providers than we have now. There are not enough younger people entering these professions to replace the retiring members. This is not just an American issue; many other countries have the same concerns, Japan being one of them.