It is tempting to look about us and see how gadget-focused we have become. Everywhere in society, people keep their cell phones, iPads and laptops close at hand, even to the point of paying more attention to their devices than to each other.
As we create more connectivity, and find ways to engage each other through electronic and (especially) mobile devices, the direct person-to-person connection may become lost in the glitz. This can be true in every walk of life, including health care.
As a rule, doctors went into medicine because of the reward of person-to-person interaction – the human touch. It is that very-human interaction, that special, trusting relationship, that is at the core of medicine. And, as we develop better connectivity and devices to enable such connectivity – like with the rest of society – it might be easy to lose sight of the central, human-to-human relationship that is the essential kernel of health care, of helping others.
Can we achieve high-touch, high-tech health care? Can we remember that, with all the devices at our disposal, the important thing is to use the tools well – to use them to help people – without becoming so gadget-focused that we lose sight of our mission? I would propose this as a “New Year’s Resolution” for the health care field.
The proper use of our tools
Health care has been technology-intensive for many decades, particularly in hospital settings. Powerful imaging technology, surgical assistant tools, and a myriad of medical devices have been the attention-getters for some time. They have been embraced by the healthcare establishment, because their utility is evident, the results are immediate, and their use results in billing events.
Much of health care, though, is information-intensive. Medical evidence is vast, and the volume of knowledge overwhelming. The Internet – the most powerful democratizing force of modern time – has brought “health data” to everyone on the planet: good data, bad data, wrong data, charlatanism, cutting-edge technology, falsified technology, social sharing of experience, and the ranting of individuals with personal agendas. It’s all there.
Given all this, the role of healthcare professional becomes one of “interpreter of a vast body of knowledge in order to help the patient.” To accomplish this, modern healthcare professionals need to be able to easily tap into trusted sources of information, tempered by professional experience. This is where modern Health IT becomes an important and powerful tool.
The expectations of service from healthcare professionals has changed in the past decade. It is no longer okay to expect to be the source of information for patients – one must be its interpreter. And it is pretty difficult – one may argue that it is, in fact, impossible – to offer cutting-edge service to patients without the information technology tools now at our disposal.
Modern Electronic Health Record (EHR) systems, more than being simply ways of legibly capturing the documentation of clinical encounters (chart notes), are becoming tools that capture Clinical Quality Measures, and based upon those, offer Clinical Decision Support prompting. They are emerging as being interconnected with all those other places where a patient’s health data is scattered – labs, other doctors’ offices, the local hospital, etc.
Why has adoption of EHRs lagged in enthusiasm among physicians, while other health technologies have been quickly embraced? Likely for the same 3 reasons: their utility is unproven (in the eyes of many who “have done just fine with paper” in the past), the results are not immediate (it may take months before the full benefits of running an office using an EHR is fully experienced), and its use is not something that can be billed for. Federal incentives (the EHR Incentive Program) have helped spur uptake, but it still lags behind other technology adoption in the healthcare sector.
High-tech does not mean loss of the human touch
Another confusion that can impede EHR adoption is the belief that such tools will get in the way of the human interaction at the core of medicine – like the couple on a date in a restaurant, looking not at each other, but instead at their cell phones, texting to each other across the table. Yes, technology like this, if used badly, can get in the way. The same could be said for a paper chart, however, as well – if the focus is on the chart, with the doctor’s nose in the paper chart, rather than engaging with eye contact, then the paper chart can “get in the way” just as badly.
Instead, the professional can enter the exam room (or in whatever setting the encounter takes place), portable device in hand (laptop, iPad, etc.), and can set the device down on a counter, can sit down, and engage the patient eye-to-eye. Human-to-human. Pay a visit. Be given the gift of being let in to a person’s life, just for that moment, and talk about health concerns, health fears, and personal private issues. Nothing takes the place of that.
When it comes time for information sharing – reviewing recent lab tests, reviewing medications, e-prescribing what needs refilling – then the portable device is opened up, and viewed together. It becomes a conduit for participatory care. The technology does not present a barrier to interaction; it is used as an important resource for the benefit of care.
When done right, paying attention to the proper use of technology and also to the fundamental human interaction that is the core of (and the reward of) medicine, high-tech tools actually facilitate high-touch health care. Doing this right should be our New Year’s Resolution.
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