On a recent post titled "Improving Preventive Care Compliance" I nudged my clinical colleagues to be more proactive in reminding patients about needed preventive services. I made comparisons to service notifications that are typical in other industries and the relative paucity of this practice in clinical medicine. I also provided an example of how technology is being applied to help doctors do a better job.
One of the great things about blogging is its worldwide reach, and the great feedback that I receive on what I write. A young physician named Jessica read my post and provided what I think is an important perspective on the topic of IT and barriers to wider adoption by physicians. If you are an IT professional or a developer of health IT solutions, this is definitely worth a read. I'm sure Jessica speaks for all clinicians on why IT adoption is a two-way street.
As a doctor myself, I am pleased to see this comparison. It is all logical and certainly a great solution for automating routine documentation. There are certainly challenges, however, and the statement you made below, Bill, urged me to comment (although a bit off topic of the article.)
You commented "so doctor, no more excuses!"
I recently attended an eHealth conference in Gothenburg, Sweden (www.mie2008.org) which was a great gathering for the scientific eHealth community, as well as a chance to meet with the vendors of Scandinavia that are well represented in this area of development, whether in the hospitals, primary care setting or even in the community. My bottom-line observation was, eHealth is gaining speed!
Anyhow, I was particularly impressed with a lengthy chat I had with one of your IT savvy partners from Microsoft Sweden. He was the "how and why" guy. So basically, he was talking to me about "How can hospitals, healthcare professionals use what they have more effectively?" and "Why are we so inefficient with what we have and what we use today and is there anything hospital IT departments can do to effectively adapt to end users needs without implementing a whole new operating system? Is the change that is needed based on workflow patterns and training to effectively use what we have? Simply synching outlook for appointment challenges between the ward and the out-patient clinic, bed-managing through an interactive network, etc.
To give everyone an example,
As a junior doctor for the NHS (in the UK) we received an induction, where apart from standard information about hospital policy is given, the IT specialists of the hospital give a training session, which was superb...but not enough.
I started my first shift as a junior doctor on a night shift. I was fully supported by my senior doctor staff, nursing staff to be effective and prepared for all encounters. But when I needed to sign-in for the first time onto the computer system to check lab results of an ill patient...I reached a dead-end, no IT tech was available to authorize my newly created account...
My battle didn't end there and I was one of the few doctors (who bothered) to approach the IT department of my hospital pertaining to my disruptive work-flow experiences.
First of all, it was a challenge to get a computer engineer/technician on the phone. After so many attempts I began to wonder WHY? So I once brought it up with my colleagues during lunch, who one of which had a mobile number to one of the IT techs that was kind enough to help out the junior staff. It, furthermore, generated a heated debate with all doctors at lunch that day wondering, "What do the IT technicians do day in and day out in a busy hospital?" Surely I would list supporting end-users with the services they are implementing a key task within their work list.
Second of all, it would be of great benefit to see the health care environment working together on this enormous 'change-of-paradigm-within-the-healthcare-system' sort-of project.
Doctors are often considered as the ones not wanting the technology. Being brief, this is not true. However, I can sympathize and even agree with my senior colleagues and non-IT approving ones that without support and incentives, this will never win the approval of key end-users.
I conclude with my statement for hopes of a diplomatic discussion with the IT health techs out there reading Bill's Healthblog..."Where are you guys?"
I can imagine you have lots to do with supportive, technical aspects of the job but I would encourage you to provide better service to end-users...whether through brief workshops during lunch or through a user info-line hospital staff can reach!
Thanks for keeping folks on "both sides of the isle" on their toes, Jessica. Your comments are very much appreciated.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft Corporation