Many might deny the 800-pound elephant cliché in the room, but deep down we all know it to be true: Information technology was – and is – supposed to save healthcare.
Tap dance like Donald O’Connor or Gregory Hines all you want, but the logic is hard to ignore. Thirty-five years ago, this publication promoted and pursued that maxim. In the mid-to-late 1990s, electronic data interchange (EDI) and the burgeoning online exchange bubble further perpetuated it, followed by President George W. Bush’s State of the Union address in 2004 calling for a national movement to computerize health records.
Fast forward to today. We wield erstwhile “Star Trek”-like communication devices in the form of smartphones and smart watches, portable computing and tracking units, hand-held diagnostic ultrasound devices, and other medical devices and equipment in various stages of interfaced or integrated electronic communication.
Ah, progress. But not so fast. Amid our hard charge toward progress we’re having to slog through the Sturm und Drang surrounding IT’s dark side that may inspire at least a feeble effort to pause and reflect.
Hot on the heels of the explosion of IT capabilities followed a litany of regulations to limit – if not restrict – access to protect the privacy of some information. Of course, that only inspired maliciously nefarious computer geeks to test the boundaries of their creativity, self-absorbed cleverness, and lack of accountability and responsibility to hack into anywhere they wanted to steal or vandalize.
Now we have ECRI Institute releasing its “Top 10 Patient Safety Concerns for 2015” last month. Topping the list? “Alarm hazards: Inadequate alarm configuration policies and practices” and “Data integrity: Incorrect or missing data in EHRs and other health IT systems.”
Wait a minute. Wasn’t all of this technology designed to help and protect patients, and ensure their safety? To help clinicians and administrators be more efficient and cost effective through performance and workflow improvement? Wasn’t transparency supposed to improve processes? Perhaps the only way to achieve transparency in healthcare involves a bucket of water and a squeegee.
We might recall the sage words of Jack Nicholson’s character in the 1992 film “A Few Good Men,” when he barks, “You can’t handle the truth!”
Maybe the most creative way to combat alarm fatigue is to wirelessly integrate these medical devices with your iTunes playlist. Better yet, maybe Apple’s “iHealth” effort can license Siri’s voice to talk to clinicians: “Patient Smith is impatient about changing the channel on his TV remote.” HIPAA concerns may quash that idea.
What’s the common denominator here? IT really isn’t – never was and never will be – the silver bullet for healthcare. Maybe it could be a rubber bullet. Why?
Simple. IT is designed by humans only to do what humans tell it to do. Humans are perennially distracted, emotionally and mentally fallible, and prone to searching for shortcuts and the easy way out of anything remotely inconvenient or irritating.
Certainly, alarm hazards (the cacophony of beeps, bloops, and buzzes can be teeth-shattering during emergencies and tense rounds) and “dirty data” are not revelations within the industry. We know they’re there and that they’ve been there for years – for decades, even.
To their credit, device manufacturers – including hardware and software companies – regularly have been releasing design improvements without sacrificing utility and expected output. You probably noticed that while wandering around the HIMSS exhibit hall in Chicago last month.
Then the question for provider IT professionals might be Robert Redford’s line at the end of the 1972 film “The Candidate” after his character defeated an entrenched incumbent U.S. senator: “What do we do now?”
