Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The commercial health IT ecosystem and its implications for patients

Scot Silverstein, MD
Tech
December 15, 2010
Share
Tweet
Share

At “Background On The ‘Ecosystem’ of Commercial Healthcare IT” I wrote:

… In reading about HIT difficulties it is important to understand the “ecosystem” of commercial health IT, that is, the identity and nature of the principal constituents and stakeholders, and their interrelationships. Familiarity with this environment is useful in order to place the social and organizational issues affecting HIT diffusion in the proper context.

By implication, I made the case that the commercial HIT ecosystem was far from healthy.

Recently at Health Care Renewal and at another blog I visit, HISTalk, frequented largely by IT industry workers and officials, I’ve noted an uptick in comments from anonymous commenters that resort to ad hominem, strawman arguments, or other forms of logical fallacy in a fairly clear cut attempt not to seriously debate the issues but to de-legitimize serious arguments. I generally respond to such comments, but a few have been so debased here that I have simply deleted them.

Here is an example of a duplicitous strawman argument recently posted at the aforementioned other site with regard to my HCR post “21st century EMR experiments: screwing around with people’s lives in a broke city, while not having a clue what you’re doing“:

… Jumping to conspiracy theories about cover-ups whenever there is an IT problem acknowledged by an organization does not really help improve the state of health IT.

I find the sickness of the commercial health IT ecosystem very disappointing and, in fact, revolting due to the implications for patients.

Perhaps a little background as to why I feel that way is in order.

I believe my background is not too dissimilar from the background of many physicians, who have had similar experiences. The following is therefore not so much about me, but about the challenges of medical training and practice in general and the life experiences imparted.

Pre-informatics, while a resident at Abington Memorial Hospital in Pennsylvania and then as a Manager in a regional transit authority’s medical department, I handled situations such as these:

  • Being admitting officer in the ED in the busiest night, ever, in the hospital’s history to that time, New Years Eve 1985-6, having to see perhaps a hundred patients and admit ~ 30. The ED staff needed to — and did — perform flawlessly after participating in the highly upsetting and depressing, unsuccessful resuscitation effort of a medical colleague shot in the chest in his home around midnight. It was I who performed heart massage on him — open-chest style — with my gloved hands after the surgeons on the trauma team cracked his chest;
  • Running three near-simultaneous cardiac arrests in the ICU’s during family visiting hours, while being trailed by a Mennonite minister-in-training as an observer. Dealing with the patients’ crises and their families was not easy and in fact was extremely stressful. The minister-in-training at the end of it all after several hours stated he was amazed at how I and the intern I was overseeing kept our cool during the affair;
  • Not telling an intern colleague on the telephone whose mother I’d just declared deceased in the MICU that she had died, because his call was coming from his father’s funeral. His father had died a few days before in the CCU right next door, previously healthy but having had an MI from the stress of his wife’s condition. (The intern later thanked me for not telling him about his mother’s death until after dad’s funeral).
  • Repairing a malfunctioning GE CT scanner’s computer to get it up and running late one Sunday might ca. 1986, which permitted a life-saving CT scan of the head of an unidentified young man brought in in a delirious state. A repairman left near midnight and said it was fixed, but it was not, and service, I was told, was unavailable between midnight and 7 AM Sun-Mon. so he could not be called back. I’m not sure if this was a vendor policy or a contractual issue (either of which would reflect Titanic lifeboat-like stupidity, since people need CT scans 24×7), but due to radiology training and computer expertise I knew what the problem was and fixed it, going above and beyond the call of duty of an internal medicine resident.
  • Dealing strongly and firmly with militant labor union leaders and drug-troubled vehicle and train operators as Manager of Medical Programs and drug testing in a large regional transit authority. I was very firm in my stance about keeping these operators off the street, and getting them help, to protect the public from possible catastrophe. I was threatened more than once, including being threatened with my life, by operators I had to put out of service.
  • Standing up to a police officer and a FOP union official regarding what I believed was gross exaggeration of a minor injury, with no objective findings to substantiate the reported symptoms, multiple inconsistent findings on exam (indicative of ‘acting’), and ongoing injury-clinic (a.k.a. fraud-factory) hot pack and massage “treatments” for more than a year, to take advantage of the injury compensation system. This type of activity was unfair to truly injured personnel, to the city that had to pay for these activities at the expense of other needed services, and to the taxpayer.

Experiences such as this impart a sense of the fragility of life, of responsibility, obligation, and an understanding of the need for critical thinking and serious and uncompromising attitudes where patients are concerned into physicians of good character.

Most serious, critical thinking physicians thus would find irrational arguments coming from the HIT industry, marketing spin, petty character attacks on those who report on HIT difficulties, and other unpleasantries quite unserious and disappointing. I certainly do.

After all, IT industry personnel in large part went through educations far simpler than that of a physician. They generally have bachelor’s or masters’ degrees, have had no medical school experience, internships, residencies, postdocs, etc. They have what are essentially comfortable desk jobs, no liability for patient harm, and compared to most physicians, a cakewalk in their professional lives.

ADVERTISEMENT

On the other hand, as a physician who had such experiences, I’m a serious professional concerned about serious issues that affect people’s lives in their time of need.

I expect nothing less from others involved in aspects of healthcare that can be life or death (as my own mother recently experienced via EHR-initiated iatrogenic catastrophe).

From that perspective, I find the commercial HIT ecosystem quite disappointing indeed.

Scot Silverstein is a physician and medical informatics professional who blogs at Health Care Renewal.

Submit a guest post and be heard.

Prev

A poetry reading at Bellevue Hospital

December 14, 2010 Kevin 1
…
Next

A nurse and the system to deal with medical errors

December 15, 2010 Kevin 21
…

Tagged as: Health IT, Patients

Post navigation

< Previous Post
A poetry reading at Bellevue Hospital
Next Post >
A nurse and the system to deal with medical errors

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Scot Silverstein, MD

  • a desk with keyboard and ipad with the kevinmd logo

    EMR liability needs to go further than just the physician

    Scot Silverstein, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Doctors find incentives elusive for meaningful use of electronic records

    Scot Silverstein, MD

More in Tech

  • Why interoperability is key to achieving the quintuple aim in health care

    Steven Lane, MD
  • How Mark Twain would dismantle today’s flawed medical AI

    Neil Baum, MD and Mark Ibsen, MD
  • 9 domains that will define the future of medical education

    Harvey Castro, MD, MBA
  • Key strategies for smooth EHR transitions in health care

    Sandra Johnson
  • Why flashy AI tools won’t fix health care without real infrastructure

    David Carmouche, MD
  • Why innovation in health care starts with bold thinking

    Miguel Villagra, MD
  • Most Popular

  • Past Week

    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • First impressions happen online—not in your exam room

      Sara Meyer | Social media
    • How Gen Z is transforming mental health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dedicated hypermobility clinics can transform patient care

      Katharina Schwan, MPH | Conditions
    • Why ADHD in adults is often missed—and why it matters [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Recent Posts

    • How Gen Z is transforming mental health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nurses aren’t eating their young — we’re starving the profession

      Adam J. Wickett, BSN, RN | Conditions
    • Why wanting more from your medical career is a sign of strength

      Maureen Gibbons, MD | Physician
    • U.S. health care leadership must prepare for policy-driven change

      Lee Scheinbart, MD | Policy
    • Why the pre-med path is pushing future doctors to the brink

      Jordan Williamson, MEd | Education
    • Why the fear of being forgotten is stronger than the fear of death [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • First impressions happen online—not in your exam room

      Sara Meyer | Social media
    • How Gen Z is transforming mental health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dedicated hypermobility clinics can transform patient care

      Katharina Schwan, MPH | Conditions
    • Why ADHD in adults is often missed—and why it matters [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Recent Posts

    • How Gen Z is transforming mental health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nurses aren’t eating their young — we’re starving the profession

      Adam J. Wickett, BSN, RN | Conditions
    • Why wanting more from your medical career is a sign of strength

      Maureen Gibbons, MD | Physician
    • U.S. health care leadership must prepare for policy-driven change

      Lee Scheinbart, MD | Policy
    • Why the pre-med path is pushing future doctors to the brink

      Jordan Williamson, MEd | Education
    • Why the fear of being forgotten is stronger than the fear of death [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The commercial health IT ecosystem and its implications for patients
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...