Impact of Informatics as a Patient: Parts 1 and 2
Something weird happened to me shortly after I turned 49 just a few weeks ago; I learned what it meant to have a significant health issue. And my diagnosis came within weeks of my wife experiencing her own significant health issue. The news was surprising to say the least as both my wife and I lead active lives. Heck, up until a few weeks ago, I cycled 10 miles 5 to 6 times a week and played in a men’s recreational hockey league. Yet, here I sit in another physician office… waiting.
As one who has spent his entire career in the administrative and academic side of the healthcare industry, I’ve gained a whole new perspective on the delivery of care as a patient/caregiver. And I’ve been around the block enough times to know I’m not the first one in my situation to express the same sentiment. But it’s true. While we do a lot of things right in healthcare, there are so many things we could improve.
Being a healthcare IT researcher, I’ve been very aware of how the healthcare workers I encountered used technology. For me, the jury is still out on how well healthcare workers use the technologies in their practice. Some workers appeared to be very comfortable in using the technologies. They explained what they were doing when entering data into the computer, and were able maintain eye contact at appropriate times. These workers balanced the high-tech with the high-touch and as a result I found myself considering them the most competent providers in my care. Other workers appeared to fumble with the computer screen and were not reluctant to share with me their frustrations with the EHR.
Believe me I understand the frustrations some care workers have with the EHR. I’ve conducted enough research on the EHR to know we have not yet reached the “HIT Promised Land,” but please don’t bring your EHR frustrations on stage with you when treating me. I have enough concerns of my own and it’s hard to empathize with your “trivial” technology issues when compared to the obstacles I have yet to overcome.
Impact of Informatics as a Patient: Part II
Last month, I shared my experiences as a patient undergoing a round of tests for an unexpected health issue. Having been on the administrative side of hospital operations for most of my career, I now have a new worldview of how we do healthcare. Some things we do great. For other things, well, there’s room for improvement.
The hospital operations world expanding its capabilities to better harness healthcare information via technologies is one of the things we are starting to do well. Is there room for improvement? Absolutely, but we’re moving in the right direction. Moreover, the evidence we at HIMSS Analytics are gathering clearly indicates that there is a benefit to the hospital when using an advanced electronic health record. Benefits have been evidenced in a wide array of areas to include clinician satisfaction with access to patient information, as well as clinical performance on the value-based purchasing measures. Other projects at HIMSS Analytics continue the theme that the benefits of health information technology (HIT) are real and expansive. These findings suggest hospitals will gain much by investing in HIT.
But this brings me back to my new worldview as a consumer of health. The hospital I am having my surgery at recently went “live” with their computerized provider order entry (CPOE) system. As a healthcare IT researcher, I can’t but think, “what a wonderful time to conduct an observational study of the challenges of implementing a CPOE system.” As a patient, “NOT!!”
I recently sat through my pre-admission testing watching the clinicians struggle to understand how the CPOE system works. After watching the nurse and tech scroll through screen after screen, my nurse finally turned to me and said that the physicians in the hospital had decided to “boycott” the CPOE system until the New Year. WHAT?!?
Clearly, from the administrative perspective, this hospital’s administration understands the value of HIT otherwise they would not spend scarce resources on this technology. But the challenge this hospital (and many others, I suspect) has, is effectively “selling” the true value of the CPOE system to the clinicians. We have much work to do in this area and it suggests there is great opportunity for vendors to provide best practices to their clients in demonstrating the value of HIT to clinicians, not just the administration.