ss wrote, [on 5/20/2009 8:29 PM]:

> Hi Johnson. You have moved to the "dark side" have you?
> You are a hospital administrator.... :D

Interesting article I just came across. Though written with a US slant,
I suspect it may be true for India, and elsewhere, as well. Thoughts?

http://news.cnet.com/Why-are-doctors-such-Luddites/2009-13836_3-6249511.html

Why are doctors such Luddites?
May 20, 2009 4:00 AM PST
By Charles Cooper

During the course of a normal business day, Gregg Feinerman likes to
send out Twitter updates. He's just like tens of millions of folks
around the country.

But there's a difference: Feinerman is a Lasik eye surgeon.

"All the people working in our office are doing it, anyway, and I said,
'Why not also do it for patients?'" Feinerman said.

Feinerman's tweeting obviously is a rarity for those in his profession.
More than a decade after the Internet went mainstream, only an estimated
17 percent of physicians have electronic health record systems.

The big trade associations representing the medical establishment, such
as the American Medical Association and the Medical Group Management
Association, can't estimate how many of their members use the
microblogging service, or for that matter, how many of them deploy
consumer-facing technologies in their daily interactions with patients.
But if anecdotal evidence is a fair barometer, assume the following:
Doctors who grew up in an earlier era are likely to cling to their
notepads and pens until the day they retire their stethoscopes. For
their younger colleagues, by contrast, consumer technology is just
another way to connect with patients.

In its Orange County, Calif., offices, the Feinerman Vision Center staff
has set up a Mac notebook in the waiting room with a private Twitter
account. As an eye operation concludes, updates go out that enable a
patient's friends and family to read how the procedure has gone.

"It's just a different way to do outreach," Feinerman said.

So why aren't more doctors early adopters of services like Twitter? As
soon as a new MRI machine or microscope comes out, they tend to be all
over it. But practitioners say information technology is hard for older
members of the profession to incorporate into their daily routines.

In part, that may be because there are few applications in health care
that actually delight doctors. There are still no medical equivalents to
Apple's iTunes or iPhone. And like the rest of us, doctors are creatures
of habit. But change is happening. With each graduating class of
doctors, more physicians feel comfortable with technology.

A survey published in December by Vanderbilt University Medical Center
hinted at this trend, though from a different perspective. The survey
focused on doctors, mostly on the younger side of the spectrum, trained
in IT-rich environments. Of the doctors who wound up working at offices
with more rudimentary systems, the vast majority expressed unease about
their ability to offer proper care to patients.

A medical generation gap, if you will, is coming into fuller view. In
fact, it's something I first saw a few years ago, when I was rushed to
the hospital after a hard fall that cracked my head open.

Upon my arrival at the emergency room, the thirtysomething physician who
attended to me took notes on a tablet computer. He could then transfer
the data from the consultation to a central server over a wireless
network. (He also had a high-end smartphone hanging from his belt, just
in case.)

As a technology reporter, all this intrigued me more than learning what
was going on with my badly smacked noggin.

The doctor told me that age--usually the 40th birthday--often defines a
physician's predisposition toward incorporating high tech into his or
her daily interactions with patients.

A few hours later, I was in the recovery room when another ward doctor
approached me. As he took out a pen to scribble into a notebook binder,
I just had to ask.

"You don't like tablet computers?"

He gave me a hard look and mumbled something about how it wasn't his cup
of tea. I'd say he was at least in his mid-50s. That was all I needed to
know.

"If you don't use tech, per se, in your daily life, at all levels, and
you're not comfortable with it, then it's unlikely that you're going to
be as speedy (to embrace) technology," noted Dr. Todd Rothenhaus, senior
vice president and chief information officer of Caritas Christi Health
Care, the second-largest provider in Massachusetts. "If you're not a
touch typist...or if you never use a mouse or are accustomed to using a
PC as part of your daily activity, then there's going to be an enormous
barrier."

Rothenhaus may be right. The hope within the Obama administration is
that many of those barriers will crumble in the aftermath of the passage
of the $787 billion economic-stimulus package, which includes $19
billion for health information technology and another $10 billion for
the National Institutes of Health.

Clearly, the U.S. population is behind a concerted effort to digitize
medical records, according to a recent poll (PDF) conducted by NPR, the
Kaiser Family Foundation, and the Harvard School of Public Health:

    "Fully three in four say it is important for their health care
providers to use electronic medical records (EMR). A large proportion of
the public also sees benefits to nationwide adoption of this technology.
Majorities say that if the United States adopted greater use of an EMR
system, their own doctors would do a better job coordinating their care
(72 percent say this is at least somewhat likely), that the overall
quality of care in the country would be improved (67 percent), and that
fewer people would get unnecessary medical care (58 percent.) Just over
half (53 percent) say there would be fewer medical errors."

In theory, that sounds like a slam dunk. But life usually turns out to
be a bit more complicated. Consider the experience of James Dom Dera. An
assistant professor of family medicine at Northeastern Ohio Universities
Colleges of Medicine and Pharmacy, his practice made the decision to
become a "paperless office" two years ago. However, the transition to
electronic records proved more difficult than he envisioned.

Dom Dera, who was accustomed to quickly jotting down notes taken during
patient visits and flipping through papers, says that only in the past
year has he gotten his typing groove back.

"I'm actually starting to see the benefits of a class I took in high
school: typing," said Dom Dera, who, at 37, is relatively young. "I've
gotten pretty good at typing and clicking while still maintaining eye
contact. At the same time, I'm cognizant that sometimes it's more
appropriate for me to stop typing, close my laptop, and just listen. I
guess that's the art versus the science of medicine."

Dom Dera and his colleagues, including the nursing staff, now use tablet
PCs connected to a wireless network. Nothing is stored locally, and the
data gets transmitted in real time without the need for a Save button,
he said.

That doesn't sound anything like my doctor; he's terrific but definitely
old-school. Getting back up to speed when it comes to using a keyboard
only hints at the challenges older physicians face in trying to adapt to
a world in which new technologies regularly proliferate throughout the
larger society.

"That's exactly it," said Lasik surgeon Feinerman, who is 42. "I grew up
in the computer age. This is just my generation. I still feel old when I
come to the office, and most of the staff is in (its) 20s and 30s. But
I'm trying to use tech and have a proactive attitude to make our
practice fun and keep people in touch."


-- 
((Udhay Shankar N)) ((udhay @ pobox.com)) ((www.digeratus.com))

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