The Doctor vs. IT Conflict – The Battle for Innovation is Here

by Fred Pennic

Healthcare-IT

I think I know everything syndrome…

I just left the healthcare industry for the second time and it’s sad the level of ignorance and superstition that exists around computers… and database design especially.  The entire industry treats computers like big electronic pieces of paper.

They print things they can easily email, they manually enter in things they could easily write a form for, and they perform repetitive manual tasks they could easily script.  It’s pathetic how far behind the industry as a whole is and the people who work in it are so close-minded I don’t see how they ever get anything done.

 

Are you the problem?

Part of the problem is the doctors.  Doctors think that because they’re doctors that they know everything.  Several times I’ve had one doctor or another tell me specifically how they wanted me to do something in a database.  They didn’t know the first thing about it, but they heard a few terms here and there so they decided to run the show.  And here they are in meetings insisting that I follow their HA architecture that was just ridiculous.

I got a reputation in my company for being difficult to work with because I always called them on it and told them to let me do my job.  Then they would complain and my boss would be at my desk the next day.  It’s just incredible ego to think that you’re an expert in all fields because you’re an expert in your own specialty.

 

However, doctors aren’t the only problem.  Vendors are also a huge problem because they’re very slow to adapt to new technologies.  And by slow, I mean 15-20 years too slow.

We’ve had so many vendors who only code against SQL2K.  Their support personnel are pathetic to say the least as well.  These vendors know nothing.

And they’re guiding hospitals in their implementations.  And of course now you’ve got the blind leading the blind because while there’s nobody at the vendor who knows what he’s talking about, there certainly is not anyone at the hospitals to call them on it.  And when they do get someone in there who knows what they’re talking about they can’t keep them because what really good IT person wants to work with an entire floor of people who don’t know the first thing about IT?

 

Non-IT staff given positions in IT

The biggest issue we had with staffing was that everyone who does the hiring thinks that you have to have hospital experience to be able to work in IT at a hospital.  So they end up hiring ex nurses or other clinical people and give them jobs as programmers, system admins, etc.  These people don’t know the first thing about being in IT or about C# yet they’re given positions based off of their hospital tenure.

So someone who wanted a career change could come in as a Sr. Programmer yet they have never even had a simple online coding course.  So now they’re in there trying to figure this stuff out.  They’re architecting solutions that they could barely qualify as end users for.  And anyone in IT who knows what they’re doing has to put up with this idiocy.  And make no mistake… it is idiocy.

 

To scared to change

The industry itself has too many older managers in it and they need to bring in some fresh blood that actually knows something about IT and how to actually get things done.  As it stands they’re just too scared of the change, too scared of the data, too scared of being sued, too scared of pissing off the doctors, and too scared of technology in general.

Oh sure, they’ll bring in iPads for the doctors to carry around, but big deal.  They’re not doing anything cool with them, and everything they put out there costs tons of money in support because they were not put together correctly.

Want a perfect example of how far behind they are?  Whenever you go to a new doctor you still have to fill out all that damn paperwork by hand don’t you?  You have to put your name, address, SSN, DOB, etc. on like 9 forms.  Doesn’t that sound like something they should be able to get past by now?  And there’s more to that specific story than just being afraid of computers.

That particular one is caused by the system itself.  I won’t go into specifics though.  I have also seen plenty of people print online forms, fill them out, and then scan them back in and store that into the DB in a text column.  Seriously?

Here is proof!

Check out this shocking article we wrote about how bad it really is (with statistics) – 12 Little-Known Factors that Could Affect Your Practice and Your Livelihood

 

From the 80’s to 90’s to…..

So what can they do to change?  How can healthcare move into the 80′s?  For starters they can hire some younger more hip managers who understand how IT works and the benefits it brings, and give them the power to do what they need to do.  Next they can stop hiring from hospitals, C# coders, or SQL guys don’t have to know crap about your business.  They have to know their business, which is IT.  And they’ll have to pony-up the money for some real IT folks.

IT folks aren’t going to work for peanuts… not when they can go somewhere else and get $20 to $30K more.  Oh yeah, and you’re also going to have to start treating them like they’re professionals.  IT guys don’t want to hear how much the doctors know about IT.  They want you to let them do their jobs.  So seriously, stop treating them like they’re nothing compared to the doctors.

Doctors are essential to hospitals, but your IT staff is too.  It’s getting so that hospitals are crippled without IT.  So why do you still insist that all IT guys are the same?  Hell, even all janitors are not the same.  I can easily tell the difference between one who cares about what he does and one who doesn’t.

 

Healthcare is in for a rude awaking

Here’s a scoop for you.  Healthcare is going to need to get their act together or else.  The government is mandating that everyone have their health records in a meaningful use format by 2015 so the time of getting by on the idiots you’ve got is over.  You’re going to have to get some real talent and do what it takes to keep them.  If that means paying them a good salary, and listening to them, then all I can say is ‘you poor baby’.

Hospitals jump through hoops all the time to attract some new doctor because of what he brings to the network.  If anyone in healthcare is reading this then you’d better start planning now.  Start gathering some talented IT guys and let them do their jobs.  And NO, before you ask, you don’t know what IT talent looks like.  Get someone to help you find that talent.  And I’m not talking about recruiters either.

Go to the Microsoft MVP site and Google someone in the field you’re looking for and start emailing them.  Ask them to help you interview a few guys.  I’m sure they’ll charge you a little, but it’ll be more than worth it.  Then once you get these guys on staff don’t treat them like second-class citizens to the doctors.  You’ve got no choice anymore.  You have to do something.  You can’t keep this up.

 

The waiting game

My guess is that it’ll probably take about another decade before this starts really turning around though. Here’s to waiting!

Sean McCown, contributing editor for InfoWorld describes why healthcare is not ready for innovation and why he is leaving the healthcare industry for the second time.

The following two tabs change content below.
Fred Pennic is the founder of HIT Consultant, a social community devoted to healthcare IT professionals. Fred has significant experience in HIT field as a management consultant and has contributed his thought leadership to publications such as Healthcare IT News, Physician Practice Journal, etc.

Signup for weekly tips

Get weekly marketing how-to guides delivered straight to you email

Subscribe to our mailing list

* indicates required
  • Patrick Green

    I agree with you completely. It is hard to be very optimistic on this front!

  • Kevia04

    Fred, You read my mind.I used to work for an EHR Vendor and you are correct on all counts.People are treating the situation like it’s the “Elephant in the room” and it won’t improve until they acknowledge it.

    • http://getreferralmd.com/ Jonathan Govette

      Thanks Kevia, We are all hoping it gets better soon.

  • RLB

    I agree completely and am so discouraged by lack of knowledge and being treated badly by doctors, I am also leaving the field of providing support to go back to working with data instead of people though I feel guilty for abandoning the end users and taking my experience a knowledge away from helping them get with the program. I cannot watch the mess this had become. Yesterday a nurse printed a scanned on hand written H&P so she could put it on the chart for surgery! All the effort to make this health record electronic for efficient patient care is for naught when providers will not move forward with progress. What a waste of time and money for implementation and training and support when you let physicians keep their orders and clinical documentation on paper and the staff keeps printing information and logs instead of using the computer to look for the information and run reports to see the data. After 5 1/2 years of passion and excitement boldly going into the future, I’m giving up and applying my skills, knowledge and abilities elsewhere as it’s too depressing to maintain hope.

  • Rachel Phillips

    Fred you couldn’t be more on the mark if you WERE the mark! That’s why I as a healthcare professional have been developing (with talented IT professionals that are very innovative and respected) AFFORDABLE “automated” web-based process tools (first process) then worry about documentation. The current EHRs on the market are just that… disorganized, multi-entry sited, prone to error, not user-friendly or savvy with different healthcare team needs. The electronic charting is so fragmented that consolidation of clinical information is impossible… that’s why nurses and physicians are still hanging onto paper versions in order to arrange the charted information in some form of order. The effort to keep up with charting takes over the time you have to take care of patients… that is not the proper use of technology. Technology should ease the user entry requirements and automate a lot of processes that are currently being performed by telephone calls, faxing etc. Hospitals have bought into these “clunky” extremely expensive systems due to the government’s deadlines and incentives and this is too bad. Because our company has realized that due to these pressures with their new EHR systems, we are creating affordable web-applications for key processes in the healthcare delivery system that historically have caused a high waste of funds, that can relieve a hospitals struggle with the EHRs, Then we will create a web-based EHR around that spine of processes in a way that nurses and physicians spend LESS time entering info. Starting out 28 yrs ago as an ICU RN

    • http://getreferralmd.com/ Jonathan Govette

      Amazing thoughts Rachel, I would love if you had time to write a detailed article about your thoughts on the industry, your job, or even EHRs so we can feature you on our website. Would you be interested?

      • Rachel Phillips

        Jonathan,

        I am interested in writing a detailed article on the industry issues with EHRs and solutions to these issues. What is the word/character limit, format of images? Can I use other article quotations to validate points?
        I’m not sure I can share my contact information in the general forum but you can visit http://www.medrok.com to access my contact details. Thank you.

  • Elena Buran

    I understand you. But I think the problem is deeper than it seems. Technicians who work with technology, do not see that the medicine can cure, but can … kill by the same equipment, if not do subtle differences in the organization of data. I think this is the main reason that doctors do not want to trust computers. They prefer to leave the responsibility on themselves. Computer today – is indifferent machine with mixed values. No clear search paradigm, actually such a paradigm, which was clearly aimed at healing. I came across this by studying people for many years as a psychologist, and learning Web 3.0 as a marketer. I saw that you need to specify algorithms search and organize documents RDF in Graph is not as programmers do now. They come from external data. For doctors and psychologists is useless. Need for physicians to documents RDF and interfaces have focused on behaviors, decision-making methods (thinking), the level of personal energy. need the ergonomics in organization databases. I’m working on it, I have a database that I use to make and develop a typology for search algorithms. I do it for education, but I know that all areas that deal with human beings have the same problem. My system is quite versatile. I think need a mediator between doctors and programmers. Doctors engaged in physiology, programmers – appliances. I think, at the time will use psychologists, psycho-physiologists as intermediaries between doctors and programmers.

    • http://getreferralmd.com/ Jonathan Govette

      I agree with you Elena,

      There definitely needs to be a middle man versed at doctor and tech speak so that both sides understand each other. Right now there is a lot of mis-communication when creating these EMR programs that are out today. They just do not work efficiently.

      thanks again for your great comment.

  • Tim Cook

    I agree with Sean on this however, there are many IT experts that think healthcare information can be managed the same as other industries. Healthcare concepts are not nearly as well defined as one would initially think. Join me on Google Plus to discuss solutions based on 15 years of research in this area.

    https://plus.google.com/u/0/+TimothyWCook/posts

    https://plus.google.com/+MlhimOrg/posts

    • http://getreferralmd.com/ Jonathan Govette

      Thanks Tim