STORIES & SOLUTIONS FOR THE MODERN BUSINESS USER

A few weeks ago, I had the opportunity to attend the day-long CHIME CIO Forum that precedes the HIMSS conference in Orlando. It’s a great get-together; there is much hobnobbing and networking with smart CIOs and vendor executives, as well as a slate of speakers that challenge the audience to think beyond our typical world of healthcare information technology. One of the lectures was given by Kate Sheridan, and she stopped me in my tracks with her wisdom and insights.

You’re likely reading this on one of the last days of the HIMSS annual conference, or maybe just as it’s ended. If you attended HIMSS this year, you might be suffering from PHES (Post-HIMSS Exhaustion Syndrome). And before you go where I know you’re going, let me cut you off and tell you that I do not know the proper ICD-10-CM code for PHES.

I was recently at a presentation with the entire C-suite of the hospital in attendance. We were talking about technology and listening to a few vendors predict their future as well as ours. A slide was projected showing data interfaces coming from multiple sources (patient, health system, payer, etc.) coming together with an algorithm at the center. And voila, from The Algorithm (my snarky capitalization added) came forth healthcare recommendations for the patient’s care. It was a moment I’d dreamed about, but never before witnessed.

I recently wrote about how I always try to follow the vendors’ recommendations when implementing healthcare information technology (HIT). I’ll summarize my thoughts in case you missed them: I want to work with vendors who know what they’re doing and have done similar work before. I expect those vendors to understand my business needs and wants, and have solid best practices about how best to achieve those needs and wants with their technology. I try to follow those recommendations unless I or my team can articulate operational or clinical reasons negating the vendor’s directions.

With New Year’s Day in our very recent past, I thought it appropriate to propose some resolutions for those of us in the healthcare IT trenches. These are in no particular order, and like all resolutions, I make no commitment to following any of them myself.

Medicine has been plagued by a culture of paternalism since . . . while, since forever. It’s still around, of course, but we’ve come a long way in the last few decades. I cringe when I watch movies from the 1940s and 1950s portraying a physician sharing private medical information with a woman’s husband because she couldn’t be trusted to understand complicated health information. Or maybe because she would react “hysterically” to a poor prognosis. While those sexist stereotypes are hopefully on their way out, I still see some physicians continue in less obvious, but still paternalistic, ways.

I have to admit that doctors often confuse me. Now I know, if you’re a regular reader of mine, you might think that’s odd because . . . I am a doctor. Yet still, sometimes my colleagues do things that I cannot explain. Because I focus on the cross section between technology and medicine, you can reasonably predict that I’m not going to be writing about why doctors choose a foreign car versus a domestic one. Nope, I want to deal with doctors and their habit of mouse clicking when no mouse click is needed.

Let me recap my previous blog post: I made the argument that the customer (aka EHR user) doesn’t always know what she wants, and it’s up to the IT analyst to provide for the users’ needs. I also posited that standardization and EHR vendor alignment is often a good thing, and that sophisticated healthcare systems across the country are pulling out perfectly good build to replace it with recommended configuration from the company that produces the software. Some IT folks are understandably uncomfortable with these changes because they now see themselves as “the heavy” and must tell end users that they can’t always get what they want.

You may have been taught that the customer is always right, but it’s been well-established that the customer is most certainly not always right (see my posts here and here). Plenty of successful, innovative business owners point out the fact that often, the customer has no clue:

I’ve been thinking and reading a lot about curation recently. By curation I mean allowing experts to make decisions for those of us who are not experts. My first experience with curation happened four or five years ago. I walked into an optical store with my wife to look for some new frames. My vision is so poor that when I don’t have my prescription glasses on, I can’t really see much of anything at all. So, you can imagine how helpless I am when I take off my glasses to put on a pair of frames with no lenses. Sure, I can look at the mirror from an inch away and maybe have an opinion, but c’mon! That’s not very effective. Hence, I typically just put myself in the hands of my wife.