One of the topics I write most about and have also done a considerable amount of consulting work on is improving and optimizing health care information technology. I hate to say it, but after a few years of doing this, I’m starting to despair a little from what I’m seeing. It’s a question I never thought I’d ask: But will health care IT ever really get to where it should be? Improvement is desperately needed — even small tweaks can be made to our electronic medical record (EMR) systems to help improve workflow for doctors. Information technology in its current format is the number one frustration for doctors and nurses across the United States. And it’s responsible for much misery on the front lines of medicine as an unacceptably large amount of time is spent navigating them.
Here are three reasons why improvement is uniquely difficult:
1. Wrong customer: administrator not end-user. After attending many events and networking meetings in health care IT, one thing has become abundantly clear to me: We (meaning doctors) are not the people that health care IT folks are catering to. It’s the hospital administrations. Can you imagine if great companies like Apple totally disregarded the end-user experience like that? This is one of the prime reasons we find ourselves in this absurd situation. As an example, I recently used the latest version of Siri on an Apple device. And how brilliant it was — far, far superior to any voice recognition software I’ve used in health care and designed with the user in mind.
2. It’s a monopoly once installed. Once health care organizations have spent millions of dollars on a particular EMR, the IT vendor is truly “in.” The organization is stuck with it no matter what and can’t just switch to another one if they don’t like it. Therefore, what incentive is there for the IT system to really get better?
3. Lack of strong voice. I was talking to a very intelligent doctor who was bemoaning how he was spending the vast majority of his day at a computer screen. Certainly not why he went to medical school. He said something very thought-provoking: “I’m surprised that the medical profession has allowed themselves to be so quickly turned into data-entry clerks without making a fuss.” So true. What happened to the public perception of a doctor — the fierce patient advocate who always stood up for good medicine? Why is there not a strong national movement to improve health care IT?
Even the most hardened technophobe doctor would acknowledge that technology represents the future in all aspects of our lives. But we want good technology that is fast, efficient and seamless enabling us to be doctors. We don’t want reams of garbled data that transform our patients’ stories into tick boxes. We want fast, mobile order-entry systems. We also want an acknowledgment that the medical profession has to remain a social and personable profession—not one where the frontline heroes are turned into “type-and-click bots.”
When I meet health care IT folk, it often seems that we are in two separate worlds. I’m quite an optimist by nature and hope I’m proved wrong about this never improving.
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.
Image credit: Shutterstock.com
