Tuesday, July 14, 2009

Grand Rounds & Health IT: The man behind the curtain is..... Forrest Gump?

Good reading awaits at this week's Grand Rounds, where Dr. Joseph Kim invited bloggers to share how IT is changing healthcare.

Healthcare is full of tech-facilitated miracles. I think health care technology's best successes so far lie in applications aimed at individuals. My daughter's cochlear implant is one great example.

A cochlear implant (CI) does not make my daughter a "hearing person." But it certainly gives her the opportunity to access sounds and to make meaning of them in a way that's very similar to what people with normal hearing can do.

Deaf people don't have surgery and wake up "hearing" any more than you buy a computer and become Bill Gates. To realize the full potential of a cochlear implant, a user learns to make meaningful use of the data the implant provides.

Implant users can hear--and grasp the significance of--a toilet flushing almost immediately. But understanding and mastering a complex battery of sounds--like syllables, words, and sentences--has a much longer learning curve. Gaining meaningful use of a cochlear implant also requires concomitant support that's not technical at all: early education for language acquisition and ongoing speech therapy.

Think about another IT-facilitated product that fosters miracles: digital radiography. A lay person can see that digital images are sharper, brighter, more precise than those on old-fashioned films. But knowing what's normal, what's a normal variation, and what requires follow-up takes education and experience, an intimacy with both the imaging device and the anatomy it captures. Like a CI, radiography only becomes meaningful when the data is interpreted, communicated, and factored into a larger whole.

System-level application of IT, a late-comer in healthcare, is likely on a similar journey toward meaningful use. Right now, I'd say health care stakeholders are hearing toilets flush and noticing that some things are brighter than others.

I think there's a lot of other things that could be said about that.

But since I'm feeling a little like Forrest Gump today, I think that's all I'm going to say.


William said...

I posted this on Whitecoat's blog but it occurred to me that you might be interested, since it's technology-related:

I’m recovering from an open fracture of my right tibia and I’ve given history to more people than I can count in the last two months.

I’m also the poster child for adult ADD, and compensate for this by chronic, acute Palm Pilot dependence.

I found a free Personal Medical Record application for the Palm called ProfileMD Classic-
and have spent most of today loading it up with information.

I have notes in the med card in my wallet and in my cell phone directing emergency personnel to where it is located on my Palm.

I just hope it’s a case of closing the barn door after the horse has left the barn, but I now realize that I keep omitting my vasectomy from my surgical history. And I thought I’d NEVER forget that initial Novacaine injection… :-)

Barbara Olson, MS, RN, FISMP said...

I wrote, I think in the most recent post, that if every healthcare provider recounted his/her most recent experience as a patient, reform would gain momentum (and maybe authenticy). Thanks for sharing what you're doing to get your "order out of the kitchen" correctly. If we had to do as much to make a system work in other settings, like Chili's, we probably would choose not to eat out! Unfortunately, not an option for health care.

Wouldn't it be great if your data could "plug in" so that it could be verified, clarified rather than--probaby erroneously--transcribed? Might seem a dream (if we hadn't put a man on the moon 40 years ago!)

I hope you'll come back soon!

WWWebb said...

I neglected to mention that I worked as an EMT for a couple of years back in the ancient days when people bleeding all over you was mainly a laundry problem.

Place called Grady Hospital in Atlanta, GA.

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