Decision Support Converges (or Collides!) with the Information Age
It is a bigger jump than a lot of us understand to transition from the way the traditional exposition of medical knowledge exists today, to the implementation of information systems. It’s time we make that journey, even though the adoption levels are just beginning to climb the Gartner hype cycle.
The percentage of hospital settings and physicians that report they’re using information technology is going to get a lot higher, and will continue to do so much faster than the pace at which medical knowledge will be effectively incorporated into information tools.
It’s also past time for the medical profession to debunk once and for all the simplistic view that once you’ve implemented all the necessary information system tools, you’re done. Instead we need to look at what’s really on hand when it comes to the translation of medical knowledge from the way it’s still being generated to its introduction into our information instruments.
Here’s where we’re getting lost:
We’ve moved from information systems in healthcare as augmentations of billing and financial information tracking, to building and using tools that are just as much medical tools as a CT or MRI scan. We need to stop looking at this entire process as one that is techno-centric and understand that these are medical-centric systems and processes.
We also need to address the translation of medical knowledge from cellulose to silicon. To get ahead in the culture of medicine, you still need to publish in paper journals. That paper-based bias is starting to melt away, but the notion that the best evidence can be delivered through electronic information systems is not yet widely accepted on the supply side, as it could and should be for optimal, timely impact on patient care.
Work is under way to identify printed documents that might indicate a better way of doing things, and convert their content into machine-readable form. In addition, non-IT healthcare professional groups are working on better document development. These groups are engaging in ambitious translation and creative work; actually making those products available. You can only imagine what it would be like if every medical professional group started to do that.
Last but not least, the idea of creating medical knowledge in the traditional way also is undergoing some reevaluation. Web 2.0 tools are all about people communicating with each other. Tools like Twitter and Facebook already are fostering participation, communication and collaboration in medical decision making—in an iterative manner, shared freely at the point of care. The term “crowd sourcing” is an appropriate term for the way we now seek information. The significance? Crowd sourcing leverages mass collaboration enabled by web 2.0 technologies to achieve the goals of medical quality and safety.
The point of all this is to understand that healthcare is the most human of professions, and we should guard against becoming too focused on machines as mere storage facilities. We must control the structure and use of these tools, lest we lose the thing that makes us most human, the care of our fellow man.
The percentage of hospital settings and physicians that report they’re using information technology is going to get a lot higher, and will continue to do so much faster than the pace at which medical knowledge will be effectively incorporated into information tools.
It’s also past time for the medical profession to debunk once and for all the simplistic view that once you’ve implemented all the necessary information system tools, you’re done. Instead we need to look at what’s really on hand when it comes to the translation of medical knowledge from the way it’s still being generated to its introduction into our information instruments.
Here’s where we’re getting lost:
- Focus. Patient care is the flag we all salute but quickly forget in our enthusiasm to adopt technology. We need to rethink health IT, to treat it as an essential medical instrument.
- Evidence-based medicine. My hypothesis is we still have a great distance to travel on this journey. We’ve already heard many times about the negative side of this new era of automation in healthcare—stories of failed implementations, ignored alarms and patient harm abound—but there are not many stories of success.
We’ve moved from information systems in healthcare as augmentations of billing and financial information tracking, to building and using tools that are just as much medical tools as a CT or MRI scan. We need to stop looking at this entire process as one that is techno-centric and understand that these are medical-centric systems and processes.
We also need to address the translation of medical knowledge from cellulose to silicon. To get ahead in the culture of medicine, you still need to publish in paper journals. That paper-based bias is starting to melt away, but the notion that the best evidence can be delivered through electronic information systems is not yet widely accepted on the supply side, as it could and should be for optimal, timely impact on patient care.
Work is under way to identify printed documents that might indicate a better way of doing things, and convert their content into machine-readable form. In addition, non-IT healthcare professional groups are working on better document development. These groups are engaging in ambitious translation and creative work; actually making those products available. You can only imagine what it would be like if every medical professional group started to do that.
Last but not least, the idea of creating medical knowledge in the traditional way also is undergoing some reevaluation. Web 2.0 tools are all about people communicating with each other. Tools like Twitter and Facebook already are fostering participation, communication and collaboration in medical decision making—in an iterative manner, shared freely at the point of care. The term “crowd sourcing” is an appropriate term for the way we now seek information. The significance? Crowd sourcing leverages mass collaboration enabled by web 2.0 technologies to achieve the goals of medical quality and safety.
The point of all this is to understand that healthcare is the most human of professions, and we should guard against becoming too focused on machines as mere storage facilities. We must control the structure and use of these tools, lest we lose the thing that makes us most human, the care of our fellow man.