Inspiration for writing sometimes comes from odd places. This week I had a lot of time to observe many of the ways computers and information technology are used by doctors and hospitals while spending an unplanned day in their company. That, combined with my own experience installing and maintaining networks and electronic medical records (EMR) software for hospitals and clinics, seemed to be a good basis for this week's blog.
When I started working with healthcare over 10 years ago, computers were starting to come in to hospitals where they were used mainly for patient record transcription and some patient information. Most of what was entered in to a computer would be printed and filed along with to typed and handwritten records. Over time applications started to become available to assist with operating room booking, provincial health insurance submissions, and some specific diagnostic databases to assist physicians. In addition, the growing IT departments in hospitals would use databases to keep track of assets including medical instruments, beds, and even the computers themselves. Many people had a vision of eliminating paper records in favour of electronic records, real time tracking and locating of assets such as heart monitors, and doctors carrying personal digital assistants (PDAs) or tablets to create and retrieve patient records and diagnostic information. The hospitals were leading the charge by purchasing applications and systems to help manage many aspects of operating a hospital. Security was and is a major focus for the It staff who implement and manage these systems which presented more challenges. Security inherently adds complexity to any system which in turn decreases productivity and people's willingness to use the systems. For hospitals, where doctors typically have a private practice as well as their use of hospital facilities, they need access to patient information in both locations but need to maintain the security and confidentiality of those records. Private practices, if they even have computers, use many different software applications with different methods of access which causes more management challenges for hospital IT staff from a security perspective.
There have been two schools of thought regarding patient records in the medical community. On the one hand, there are many benefits to using a standard common format for storing and sharing patient information. Easy and rapid access to patient information would improve healthcare. The provincial governments in BC and Alberta, among others, are proponents of this type of standard. On the other hand, there is a sense of ownership that doctors have for patient information. Giving someone easy access to information may cause too much reliance on this information and remove some elements of critical diagnoses. Open sharing of patient information could have begin to eliminate the idea of family physicians who often know more about their patients than can be expressed in a document. My experience yesterday showed me both sides of the coin. We were at two private clinics and two hospitals where we saw technology assisting in many ways from locating the patient after I parked my car; to electronic medical imaging that could be transported easily and quickly from one location to another; to the mesh of communication that got us through a large and cumbersome system with relative speed. Through the whole experience we noted that staff was well informed and informative as well as sensitive to us as people.
In the end, the body being the amazing machine that it is, the problem rectified itself in the nick of time and saved us the risk and stress of surgery. While I did see many opportunities for IT to help further in the process, in our case I was grateful for the time taken to do some things manually. During that time the body keeps fighting on its own and in this case won the battle.
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