Health IT needs to be seen but not heard

You may be forgiven after reading some of my articles for thinking that I’m somehow “anti-health care information technology.” It’s a subject that I’ve written a lot about over the last couple of years, mainly because I feel passionately that our use of information technology at the frontlines of health care needs to drastically improve.

But let me start first by making a confession: I love information technology. I am just as hooked on my iPhone as anyone else, regularly use social media, and carry my laptop around with me most places I go. OK, let me rephrase: I love good information technology. Products and services that make our lives more connected, seamless, efficient and ultimately — better.

Where we’ve gone a bit wrong however in health care is that as we’ve rushed to make hospitals and clinics fully computerized, we have not correctly reconciled the IT solutions with frontline clinical workflow. The world of health care and information technology never came together to acknowledge one simple fact: Health care is very different from most other arenas. It is uniquely personal and emotional. It’s about human relationships, face-to-face communication, and empathy. Ours is a profession centered on human beings and compassion. Those are things that no computer can ever get to.

One other crucial point is this: The majority of our patients who require health care at the moment are not from the computer literate generation and, for at least the next couple of decades, this is likely to remain the case. Whether our profession will eventually lose its requirement for human interaction is something we won’t know for a while — but for now, it stays.

Physicians and nurses overwhelmingly want to work with better designed IT systems that are fast and easy to use, allowing them to be more productive and of course, take them back to where they belong: with their patients. Nobody wants to go back to the bad old days of paper charts and illegible handwriting. But we do need an improvement in the world of health care IT and the amount of time we are having to spend navigating cumbersome systems. Research backs this up, with some studies suggesting that physicians are now spending as little as 10 percent of their day in direct patient care — an alarming statistic.

So as we move forward, instead of IT interfering directly with the doctor-patient (or even nurse-patient) relationship, what we need is a seamless relationship as follows. For extra fun, I’m going to call this the Dhand Health IT Triangle:


This is a visual representation of what all health care IT of the future should look like. Unfortunately, what we have at the moment is more of a straight line:


This line represents the computer or IT system coming directly in between the physician and patient, interfering with the relationship and frequently acting as a barrier to good patient care. The ideal solutions of the future will be seen and not heard, working with doctors and patients to make health care better. They will be super-efficient, mobile and fully optimized with frontline clinical workflow.

As we move forward with technology, we need more triangles and fewer straight lines.

Suneel Dhand is an internal medicine physician and author of three books, including Thomas Jefferson: Lessons from a Secret Buddha. He is the founder and director, HealthITImprove, and blogs at his self-titled site, Suneel Dhand.

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