Is it the technology or the people behind the computers?
This piece from Health Care Renewal suggests it’s the latter, or the so-called sociotechnical issues. In other words, the problem is not with the technology itself, but “inadequate planning, insufficient testing or training, failing to include front-line clinicians in the planning process, failure to consider best practices for HIT operationalization, failure to consider the costs and resources needed for ongoing maintenance, failure to consult product safety reviews or alerts or the previous experience of others, over-reliance on vendor advice, [and] failure to carefully consider the impact technology can have on care processes, workflow and safety.”
In other words, it’s the people that’s the problem.
The President-elect is prepared to infuse a significant outlay of cash into a poorly-designed and fragmented generation of digital record systems. Those who are advising him are choosing to focus on the technology issues, rather than the sociotechnical issues.
And that decision may doom us to several decades of inadequate health IT infrastructure.
Related posts:
- Op-ed: Why doctors still balk at electronic medical records
- My take: Funding geriatrics, electronic records, CT-cardiac scans
- Implementing electronic records
- How the widespread adoption of electronic medical records can raise health care costs
- The New York Times finally gets it on electronic medical records
- Most hospitals still use paper records, and why money alone won’t solve the electronic medical record problem
- It’s time for every physician to adopt electronic medical records
{ 7 comments }
While the techno whizbang often gets ahead of itself and certainly needs to be controlled, the utilization as a business tool does have to be thought out and useful to all, or most, concerned. It’s fairly easy to enforce this in a regular business enterprise context, but the health industry has too many conflicting and contradictory requirements to make this easy or reasonably quick. The best example of this is the utter lack of transparancy at hospitals: Costs should be predictable and consistent, and immediately known, no later than at the point of use. The industry sorely needs a kind of reformation (or massive disruption), long overdue.
Chuck Brooks
FutureWare SCG
Sorry, but this isn’t the whole problem. The software and, especially, the user interfaces, are still quite crude and introduce many problems and inefficiencies no matter how carefully the implementation is planned or how many workflows are adjusted.
When all the IT guys are gone and it’s just you and the patient, all of the supposed benefits of EMR’s fly out the window. Why? Because now it’s up to the provider to chart and chart and chart some more. The work falls back onto the shoulders of the provider.
I for one don’t see that as an improvement in my personal work flow. Maybe I just need to learn how to type and talk at the same time.
Jeff – you do need to learn to type and talk. It’s a whole new world there.
My Internist can type and talk and look at me all at the same time.
Probably the next generation of kids who can text with their phones in their pockets like in the move “Departed” will get it right.
Isn’t this technology already in use in some major cities, such as Northwestern Hospital/related practices(in Chicago). I was visiting my daughter and went with her to a drs. appointment. When I saw the laptop in the examining room, my first reaction was “oh no”. But as we had to go to other specialists around the city, they were able to bring her history, diagnosis, etc. and saved much time (and in my mind, accuracy).
The doctor seemed to easily and quickly enter preliminary info, then focused on the patient, then updated the info at the end of the visit.
My thought would be to extract “best practices” from hospitals/practices having success with use of electronic records…and use this as a model for the rest of the medical community. I know it’s a simplified idea but thought I’d share.
It’s the fact that this technology was built on transactional, pre-internet standards that’s never progressed out of 1996 and beyond being a transactional billing engine rather than a tool to communicate and provide valuable information to both patients and doctors using today’s technology.
In essence, it all sucks. That’s why we’re developing our own from the ground up using tomorrow’s standards.
WHy dont you check out the amazing Electronic Medical Record (CPRS) Computerized Patient Record System; in use at all the VA Medical Centers. You will be surprised. It may not be completely perfect, but it is far ahead of ANYTHING else out there as far a a holistic EHR.
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