Staying the Course To Achieve Improvement

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Boston is the birthplace of the American Revolution as well as a revolution of sorts in applied medical informatics. Thus, we saw it only fitting to make this city where so many famous patient care applications were created, the location for the first AMDIS Fall Symposium. It’s also our first meeting on the East Coast.

This meeting won’t be the usual celebration of the creativity of the Boston medical establishment but, rather, lessons learned by people who really know a lot about medical informatics. 

Many organizations have ripped out decades’ worth of development and evolution for commercial systems that some thought would be safer and more likely to be compliant with future government requirements and Meaningful Use dollars. The lessons being learned already from this transition have broad applications. Venerated Boston institutions are going through some of the very same disruptive and upsetting changes that are occurring in installs across the country. 

The only thing that’s important about what we’re doing right now is indeed the quality, safety and outcomes of the healthcare we provide. Nothing else matters. If we are able to implement at a lower cost or come up with fancier screen displays, it really doesn’t mean a hill of Boston beans. In the final analysis, it’s all about healthcare. 

Rather than replace health IT systems, we need to integrate IT into the workflow of the practice of medicine. Too much emphasis has been on early adoption rather than the steady use of health IT so we can apply analytics and refinement of care. We have to move beyond adoption before we can realize the real goal and value of IT. 

Why is the constant changing of technologies a problem? Why not keep on getting the latest? Because the more you keep doing that, the less you focus on what matters the most—the data, analysis and actually making improvements on how care is delivered on the basis of that data. 

I compare the current health IT situation to learning to drive several different types of cars. For example, I train you how to drive a Mini Cooper. You get that down and then I say, rather than driving the Mini Cooper with the automatic transmission, now drive a Porsche with a standard, six-speed transmission. It’s going to take a while before you can drive a straight line because you’ve never used a clutch. After a few months of that I say now drive a Ford truck with a trailer. You would probably say this is crazy and that you need some time to accommodate for all these different technologies. You can’t be safe on the road without a significant amount of time to learn. This analogy, clumsy as it may be, is applicable to colleagues going through these health IT changes. 

We will talk about this ongoing problem during the Boston meeting this month as well as Meaningful Use Stage 2 and its potential impact on the physician-patient relationship, moving forward with health information exchange and other relevant topics. Healthcare informatics is for sure undergoing a revolution that would make our forefathers proud. Won’t you join us?