Thursday, August 26, 2010

Healthcare IT a Sacred Calling?

At my post Are computers in medicine narcotic? "Why did the National Programme for IT fail?" I observed that the healthcare IT mania/bubble is being driven in part by non-clinical hysterics who believe they will somehow "revolutionize" medicine with information technology tools that are barely able to show improvements at this point in time.

(I first heard this hysterical claim of "revolutionizing medicine" being proffered verbatim by CEO's of several large HIT vendors at a Microsoft Healthcare Users Group Meeting ca. 1997).

It may be worse.

While written with good intentions, I'm sure, now we have an evangelical article by a major medical center CIO promoting the idea that IT workers are on a holy mission (link).

... Whether we give direct care or support someone who does, we are fulfilling a sacred calling — touching human lives. Don’t discount information technology because it’s only computer stuff and nobody really knows where cyberspace is anyway. You could’ve practiced IT in any industry, yet you chose healthcare. Or perhaps healthcare chose you.

Sacred callings come in various forms. Although healthcare IT is nothing unique in itself, the element of sanctity is why I stay. If we want to live a life of significance, we must understand the depth of our calling and then perform as if our work matters. Grasp the privilege of serving humanity with your skills and talents. That is sacred.

A noble premise.

Unfortunately, the the piece then goes off the rails with extravagant commendation regarding the role of IT work in healthcare. While I agree with the overall premise, unfortunately the writer goes on to imply health IT personnel might somehow in their contributions be equal to, or even more important than clinicians:

... It is not unusual for hospitals to conduct non-denominational “Blessing of the Hands” ceremonies ... I had seen this done for clinicians at one of our hospitals and it got me thinking. What about IT? What we do is no less critical to the healing process.

Puffery and braggadocio in the extreme? Healing has been going on for quite awhile before computers, and still goes on in the current majority of healthcare settings that don't use healthcare IT - ed.]

Our hands may not touch patients, but they do touch their lives in ways unseen. Arguably, IT is the only segment that touches the entire healthcare continuum.

As I've written many times before about healthcare IT professionals, there seems to be a blur about who are enablers of healthcare, and who are facilitators of healthcare.

Self-adulatory hysterics make an otherwise good message less credible, at least outside of health IT circles.

Finally, if health IT is a holy calling, it would be holy indeed for the health IT industry to pay less attention to the holy greenness of crisp banknotes, and heed the increasing corpus of literature showing health IT might in its present form might be devolutionary, not revolutionary. And act accordingly.

-- SS


Anonymous said...

Being the knuckle dragger that I am the first question I ask is: How are we going to do this thing. The first issue I deal with when talking about computers is connectivity. This was addressed in the Aug. 24, 2010 Akron Beacon Journal article Problems swamp Internet hopes.

Akron is at the heart of the rust belt. The manufacturing jobs are gone and what is left is a large university, a polymer industry, and a surprising bio-tech industry. The concept was to create city wide wi-fi access.

A number of charities donated millions of dollars, government took a leading role and after eight years you have spotty access in a limited location.

Familiar to readers of this blog would be the problems of control, competing interest and money. Use power poles for units? No, those are owned by a separate company and they want a fee. Use traffic light poles? No, they want a separate power supply and cabling. Certainly building owners would want free wi-fi in their offices. No, they want a fee.

So here we have this great idea that will make our kids smarter, our industry faster and the community a more desirable place to live, just ask the people involved. It is not going to happen. The donations have run out, the government has moved on to other issues, and there is a whole group that wants to get paid to participate.

This has not dampened the fire in those that see the computer as the end point of society. The article closes with:

“But the state is still home to 1.6 million adults who don’t even have a computer.

But worse: two thirds of those folks don’t think they need one.”

The concept that many of those folks that do not have a computer are older and have done very well, thank you, with out a computer is never considered. The city has been unable to bring this service to the community is glossed over. All we do is beat the drum for more money and political support to get this service off the ground.

I cannot help but be struck by the similarities to HIT. The system does not work, but all we need is more money and political support, and when we get it working, at some undefined date in the future, it will be a great thing.

Steve Lucas

Anonymous said...

In recent years, some of the greatest thieves were devoutly religious, and incredibly charitable (with other peoples' money).

I, for one, pray that my patients live despite the flaws, defects, and viral care to which they are exposed from the EHR devices Congress and the White House have mandated.

Others have become religiously fanatic about the devices with mystical healing powers, anointed by the Congress, and pray here:

I understand that for those who can not get to the Church of Robotics, the IT priests have set up tele-prayers which is especially helpful for those writing the new codes for CPOE and CDS. They can multitask prayer and code.

bankruptcy said...

Does it really matter? Don't clinicians, nurses, allied professionals and other players all rely upon one another to deliver the best patient outcomes? Why do we have to be so "my dad is bigger than your dad" about it?

MedInformaticsMD said...

bankruptcy said...

Don't clinicians, nurses, allied professionals and other players all rely upon one another to deliver the best patient outcomes? Why do we have to be so "my dad is bigger than your dad" about it?

Yes, it matters very much.

Quasi-delusional beliefs such as these interfere with or prevent IT workers from being contributory team members on clinical teams.

Instead, they are often obstructionist, not responsive and not in the appropriate service mentality towards the needs of the enablers of healthcare.

See cases here for examples such as in invasive cardiology and in the ICU.

-- SS

Anonymous said...

Do you think the sacred calling speech was really a ploy to ask folks to work long hours to fix these problems at lesser pay?

MedInformaticsMD said...

No, I think it was well intentioned not deceptive. My only issue is the idea that IT contributions are as important as the contributions of medical professionals (doctors, nurses, and other allied health professionals) towards healing.

Ideas have consequences, and as expressed in an earlier comment, that idea of IT-clinician parity IMO is not helpful.

It leads IT personnel to operate outside their core competencies, disregard or under-regard opinions of clinicians, and make decisions they are no more qualified to make than laypeople.

-- SS