I read two interesting articles today: one about why healthcare information exchanges (HIE’s) are failing (it blames fax machine use) and another on ubiquity of pagers within the healthcare system.
As I read through them, I was reminded of a presentation that I once saw (I think it was at a HIMSS meeting but am uncertain) about a project to replace a white board in an ED with a shiny new large-screen display. It failed to a large degree for the same reasons faxes and pagers persist, which appears to be because the infrastructure (both physical and operational) that supports these newer technologies is not sufficiently organized or robust to completely replace them.
· The article about HIE’s laments the lack of standards and, agreements and regulations necessary for HIE’s to work effectively, but also laments that major players, especially in the payor space, rely heavily on fax machines. This article asserts (and I have no way of disproving it) that fax machines remain the primary mechanism by which patient records and prescriptions are transmitted.
· Similarly, while smart phone use is ubiquitous, there are places and times (such as the hurricanes that are part of life here in Florida) where a cell phone simply won’t work. Surprisingly, the pager always does! Additionally, not all facilities use the same “app” to replace a pager, with the result, as reported by one physician, that the physician is required to use multiple smartphone applications, some of which are much harder to use than the pager. His quote: “"I was constantly ranting about how this is ridiculous that we use technology from the '80s when we have a computer in our pocket." "Now that I have that, I'm screaming to get my pager back."”
So, I find myself wondering if our journeys into the use of technology wouldn’t be more productive if we took more time to truly understand everything that is required to achieve a particular goal, and to architect solutions that provided all the answers (even if crudely) that the current methods did so that our users didn’t wind up pining for the “good old days”.
Just thinking out loud…
The thoughts of this blog are my own, and not necessarily those of my employer or of ASHP.
Dennis A. Tribble, PharmD, FASHP
Ormond Beach, FL