EHR Spitballing - Can’t We All Just Get Along?

September 14, 2011

A huge barrier to health IT adoption is the divide between those on the technical side and those using the technology.

I belong to the Health Information Management Systems Society (HIMSS). In fact I am a HIMSS Fellow. From their website: “HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare.”

I also belong to LinkedIn, and like many organizations, HIMSS has a discussion group on LinkedIn.

Some time ago, someone posted the following as a discussion topic on LinkedIn: “I have been an implementation project manager for the past five years. The problem is the folks that work in the doctors’ offices. They don't understand technology. Period! It’s a big learning curve for them.”

There have been over 350 comments, and as you might expect, they run the gamut of both offensive and defensive posturing and opinionating. Software vendors, implementation managers, and others on the technical side have tended to align with the original poster, agreeing that healthcare users are essentially luddites and technophobes. Those on the user side have railed against software vendors and other technical people for cramming bad technology down their throats and not caring about - or taking the time for -understanding the complex work flows and clinical and business issues that exist in a typical healthcare setting.

I've been following this debate for many weeks now. There is way too much finger-pointing and labeling and make-wrong dialogue.

As long as technical people blame users for being stupid/incapable/untrainable, and as long as users - and especially clinicians - blame technical people for not understanding their needs and not understanding clinical processes, there will be a huge barrier to health IT adoption.
A major overriding issue here is that healthcare has underinvested in technology, and now is having to play catch-up. Other industries - financial services, transportation, hospitality, shipping, etc. - have spent the last several decades using and becoming familiar with technology as it developed. They went from punch cards to keyboard entry to GUI (graphical user interface) to voice recognition and NLP, and tweaked their processes along the way.

Healthcare, meanwhile, continued to generate more mountains of paper and implement dozens of intricate manual processes as they eschewed technology. So it’s a much bigger leap to go from paper/manual to so much automation overnight.

Healthcare users think that interfaces and devices (keyboards, mice, touch pads, tablets, voice recognition) are hard to use and clunky, etc., and in many ways they are, because people are not used to them.

It's going to take time to learn how to use them effectively. And in the meantime the two "sides" (technical and users) need to get on the playing field together and cooperate and collaborate more and not shoot spitballs at each other from the sidelines.

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