Friday, May 16, 2008

"I hope that some day you get your wish"

The HISTalk site, a popular, vendor-supported health IT "gossip" site, has a different standard for its reader comments than HC Renewal, allowing anonymous ad hominem and other forms of hysterical or irrational argumentation to be posted without refutation by the site owner.

In a way, this is good, because such posts may reveal sentiments held by a number of people but rarely expressed, except in an anonymous forum.

With regard to the thread I mentioned in my HC Renewal post "Physician Stereotypes and the Failure of Health IT", there have been some very interesting followup comments made. The following raised my eyebrows:

Followup from "Preston", who alleges "I have a music education degree and a Master of Healthcare Administration and I serve as an IT director for a health plan", and who as I mentioned in the earlier post paternalistically "values my medical staff for the value they bring":

... the “wisdom” that pervades your posts is a sense of victimhood…that the high failure rates in IT (please acknowledge that medicine has a 100% failure rate at keeping people alive for their desired lifespan) are due to the mystical idea that physicians have been forced to depend on IT experts to assist them with IT issues.

So, physicians and others who speak out on HIT issues in the interest of patient care are merely expressing "victimhood" (this does not seem to reflect very good reasoning), and the other statement about medicine's 'failure rates' is at best some odd, irrelevant comparison (akin to "a hundred dollars is a good price for a toaster, compared to buying a Ferrari.") I cannot even parse the meaning of the final passage in the comment.

In another comment a poster "TraynorMD" (I somehow find it doubtful this person is actually an MD) offers this hysterical, anti-intellectual, ad hominem laden comment:

Hmm - a non-practicing MD who, despite a long list of what he deems essential but unfairly ignored industry credentials, can’t seem to hold a job for very long? He’s not doing informatics physicians any favors with his whining diatribes that always end up congratulating himself for his own wonderfulness. I’m sure that’s why he can’t stand the idea of a CIO getting and holding a job based on accomplishment instead of argumentative resume-brandishing. We should be hearing from those out there getting the work done, not loudmouth bystanders.

Ironically, in the very same blog which generated the discussion thread is a link to the story of the New Zealand hospital whose IT debacle nearly killed people and caused a senior physician there to tell the press the hospital "could not guarantee patient safety."

While I sincerely hope the views I reposted above are a minority in the health IT world, they are reminiscent of feedback people who write about HIT problems receive, and not always anonymously (e.g., Ross Koppel's study on CPOE being called "disingenuous" by those with industry interests). They are certainly consistent with views I saw displayed as a CMIO myself by some MIS department staff, often in behind-closed-doors chatter by people who forgot that "in hospitals, the walls have ears."

Someone should please tell me why clinicians would want people of such anti-intellectual views and/or poor reasoning skills to be anywhere near systems upon which patient care depends.

At least the first poster admits this:

We get it. You would like for clinical IT specialists to be escalated to positions of leadership. That sounds great and I hope that some day you get your wish.

"We", I imagine, refers to non-clinicians in HIT, and I can only imagine this statement was made without much enthusiasm.

Finally, I want to make the point that I find the resistance in IT circles towards leadership of clinical IT by qualified biomedical informatics professionals quite puzzling. It's not as if the latter want to run the entire IT shop including business IT, just provide leadship in clinical IT.

It's a true win-win situation, after all. CIO's and other IT personnel get reduced job stress and perhaps longer tenures due to the expertise and presence of a cross-disciplinary intermediary between clinicians and IT (it's been said that in healthcare, CIO="career is over", as average job tenure is just a few years). Biomedical informatics professionals get to leverage their expertise and the sacrifices they made in pursuing additional training. The healthcare system benefits from improved HIT and less costly HIT errors, difficulties and failures.

And last (but certainly not least), patients benefit.

-- SS

No comments: