Monday, December 14, 2009

The arrogance of health IT?

The paperless medical record brings more than technology to an institution. It brings fundamental culture and process changes. But these changes are experimental, having withstood neither the test of time nor the rigors of clinical research according to MedInformatics MD, blogging at Health Care Renewal. He writes:

In reality, handwriting issues aside, there is little wrong with "the old medical chart" from an information science perspective. It evolved over a century or longer to serve the needs of its users. It is a simple document in terms of organization, containing sometimes complex information but in an easy to find form (when maintained by humans properly) and in a presentation style that recognizes human cognitive limitations in very busy, complex social environments such as patient care settings.

Its quasi-duplication in electronic form would serve medicine well.

...In fact, politically speaking, health IT can be viewed as a cross-occupational invasion of healthcare by the IT industry. (Other invaders are at work also, but I am only considering the IT industry here.)

The latter industry is largely healthcare-dyscompetent or incompetent [8].

I ask:

What right do the domain-dyscompetent occupants have to tell the occupees, the latter rigrorously trained in clinical medicine through years of both classroom and grueling practical experience, and in the record keeping paradigms developed over centuries, how to maintain their records and perform their processes?

What arrogance is it that drives the the occupants to tell the occupees to stop complaining about the terms of the occupation - seriously deficient experimental health IT applications - and get in line with the methodologies and preferences of the occupants?


Some will view this as Luddite mentality. I view it as healthy skepticism.

1 comment:

MedInformaticsMD said...

In fact, only those health IT amateurs with a programmable card punch/tabulator mentality and/or lack of Biomedical Informatics experience (and perhaps an inability to use search engines, and an unwillingness to take organizations such as the National Research Council and its HIT pioneers seriously) would call me a HIT Luddite.

-- SS