"Also I will, according to my ability and judgment, prescribe a regimen for the health of the sick; but I will utterly reject harm and mischief…" – Excerpt from the Hippocratic Oath.
Though the literal translation of the Hippocratic Oath is a bit old-fashioned at this point (it was, after all, written late in the 5th century), it still can remind us of why we choose to practice medicine. I hope we all strive to select therapies to best help our patients, and never do them harm.
With that in mind, we take another look at the lag in healthcare’s adoption of information technology. Last week we examined the cost implications of bringing IT into healthcare. This week, we consider the way safety concerns might mitigate HIT innovation.
Tara Grabowsky, MD
I spent the first 28 years of my career in aerospace and defense. In that industry it was the “young guns” – employees right out of college – who brought new thinking to old problems. That was especially true when we started using computers to improve the design and development of satellites, stealth fighters and submarines. When I started there were a few "old timers" who would still double-check certain calculations on the slide rule. The Intelligence Community (IC) has traditionally had competitive strategies built in; the government contracts process is designed to ensure competition. Though it is not a perfect system, it has encouraged rapid evolution and adoption of technology. My aerospace company, for example, adopted new ways of doing business using management initiatives like Lean 6 Sigma (total quality management).
Today we see everything as agile software development. Agile Alliance describes this software development process as one that promotes adaptive planning, evolutionary development, early delivery, continuous improvement, and encourages rapid and flexible response to change.
Maybe that is what is needed in health care. The HITECH act was enacted to help incentivize the industry to adopt health information technology. Maybe my aerospace company was more motivated to improve productivity and quality than the Health care industry? Think about the FAA, which manages the nation’s air space. I would say that this segment of the market is slow to adopt new technology. There are true stories that certain FAA sites use vacuum tubes and floppy disks. In that culture the reluctance to change is caused by the fear of risking lives. Could there be a similar story with the health care system? Could health care workers be reluctant to try new technology because it might hurt a patient? Perhaps we need to introduce carefully regulated competitive forces (patients being aware of choices, insurers working across state lines, etc.) into the health care market. Perhaps we can translate the lessons learned in building missiles to developing IT physicians want to adopt.