March 23, 2010 was a prominent date for the HealthCare-IT (HIT)/HealthCare-Information System (HIS) world, that was the day ACA was signed and most of these rules and regulations started developing and along with that came the HealthCare-IT boom. Just because of that date we can literally define HIT into 2 phases, pre and post-era. In Pre-era, we were using HIT but it was mainly for financial services and connecting to ancillary departments for time and money saving purposes. Then here comes ACA and we all started talking about the EHR, Database, networking and security. Obviously, some of us in the industry were talking about it before that, but that day gave us that jolt that got us to today. The beautiful by product of that jolt was the data that we are now getting and which is going to help us decide our future trends, research and Healthcare/Clinical world.
When all of this started, the HIT/IS department was treated like ‘that kid’, with whom mom said I had to like and play with, and the reason for it was, just because she said so. In her own way mom was right because that kid was going to teach me something and I was going to teach him something. That was going to play a minor but important role to make me the man she wanted me to become. Ever so reluctantly I accepted her order and became a better person for that. But now I still think of ‘that kid’ as the kid mom pushed me to be a good friend with, even though I know he is one of my best friends and I cannot see life without.
Now after 7 years, 3 months, 14 days and few hours we have achieved some great strides in HIT. When it first started, as with every other thing, change was hard, HIT had to be formed/improved, mission statements had to be developed, workflow had to be molded, people had to be convinced and trained, and we did it. We did a great job, given the time period we had and the speed we had to get it done.
Now looking at the current state of HIT, hearing the stories about current HIT department status and the data we are collecting, sometimes I feel like,
1. Did we really do a good job?
2. Are we really where we want to be?
3. Are we really collecting accurate data?
4. Are these workflows really helping our goal of patient safety and data-collection and giving us accurate information?
Some hospitals are moving to their second EHR, some are rebuilding their workflows again, some of them are rebuilding their order-sets again and some of them had to rebuild the drug database again because they realized, the system they had developed is not working for them. For almost 95% of the time, all of the EHR systems are doing the exact same thing if set up properly but some of our end-users are still unhappy and not getting the best use out of it. Some of it is happening because of the speed we had to do certain things with and at that time, we spent a lot of time planning for a long-term goal and kept looking at the bigger picture, and forgot about the small building blocks that were going to give us the bigger picture. I think before this decade is over, we need to take a little breather and see if we need to revise our mission statement again and give a deeper look at our HIT departments.
When all of this started, the HIT/HIS department was treated like ‘that kid’ who I mentioned before. Now that kid/HIT/HIS department has become a big part of our Healthcare even though HIT/HIS is still being treated like ‘that kid’. HIT/HIS departments all over the US are supporting hospitals but they are still ‘that kid’ and that’s the reason, we keep revising things and keep wasting money and time. Because of the THAT HIT/HIS Department’ status, it’s not getting enough voice, when they say something has to do with a minor building block, but because of that ‘Status’ we are getting overridden and that’s because all of the other factors are coming in before the HIT/HIS department concerns.
Now when I state the above facts, I totally understand, we are in the business of patients and we are Healthcare-IT not IT-Healthcare and that’s for a reason, but at this point we need to slow down a little and give an affirmation to the fact that HIT/HIS has made Healthcare stronger, more stable and easier. If we need to stop these rebuilds and gather better information for our patients and create a safer environment for our patients, we need to realign our mission statements again, we need to make sure that HIT/HIS departments are getting their voices heard and ‘that kid’ tag goes away and becomes a family member. We need to make sure even if this time build is going to take a longer time, that is okay because it has to be perfect and has to be long sustaining and withholding so it can face whatever is coming next. Accept and cherish the fact that HIT/HIS is going to be here as long as healthcare is and it will bring bigger and better gifts for you but you have to have a nurturing relationship, otherwise we will always be in the ‘REBUILD’ phase.