Hi Fred, This is a topic I have been trying to address for years.
In France, practitioners are mainly using the kind of software whose main selling argument is to imitate paper. Since I have always been developing information systems based on highly structured information, I have always been looking for evidence in favor of "advanced health IT against office dedicated systems". And I reached a dead end! The first reason for this is that when I tried to convince medical doctors that it is a nonsense for them to only use Electronic Document Management systems when they should use group-ware and project management systems (I mean, some way to work as a team around patients), they clearly don't get the point. The usual answer is that MD have always communicated through reports and cannot even imagine working another way. The second reason is that highly structured information mainly allows for knowledge management (KM). When I graduated, it was called Artificial Intelligence, but KM is a better term. And, as a guy that managed to have practitioners use a system that hosts a bunch of "knowledge sources" (the kind of smart agents that are controlled by a blackboard), I can tell you something highly disturbing : any medical doctor will restrain the information she stores to the data that her brain can easily process (optimizing the signal/noise ratio). It means that this "complex information that smart agents could process for her benefit" is simply not there! (with the exception of Risk Management, because it is considered "complex enough" for the MD to be willing to feeding agents with the data they need). The solution to this is rather straightforward: just switch to continuity of care, as the place where practitioners work as a team and share a lot of information they are not used to processing with their brain (say, they cannot restrain the information that get stored and will suffer from a low signal/noise ratio). But when you just reach this point, there is high chance that you realize that your customer will probably never be a practitioner ;-) This is the dead end... the moment when you realize that this box is too small and that, unless you are able to provide the proper tools for a paradigm shift, there is no use trying to sell advanced systems in a context where they will never really work. Philippe Ameline Le 30/08/2010 18:31, fred trotter a écrit : > > Hi, > > One of the experiences that I have had, time and time again is that when I > talk to doctors about Health IT, they have some basic Information > Technology > gaps in their education. They simply do not understand some of the > fundamentals of Information Technology and have trouble even understanding > what I am talking about when I talk about things like "structured data". > > Alternatively, "normal" IT people do not get some of the fundamental > complexities of the healthcare delivery process that prevents them from > understanding certain Health IT concepts. > > The kind of thing I find myself repeatedly explaining to doctors include > "Why you need to include prescription data in a normalized way in the > patient chart, rather than just writing in plaintext in a note" > > The kind of thing I find myself repeatedly explaining to IT people include > "Why billing data cannot be relied upon for clinically accurate data > mining" > > In your experience, what other things do you as Health IT people have to > consistently explain to doctors and/or IT people about Health IT. I am > looking for the kinds of things that you have explained at least three or > four times. Perhaps you have explained them enough times that you have an > impatient lecture that you have to give on the topic? > > Another way to ask the question is "If there were a FAQ for Health IT, > what > should go on it?" > > Thanks, > -FT > > -- > Fred Trotter > http://www.fredtrotter.com > > [Non-text portions of this message have been removed] > > [Non-text portions of this message have been removed]
