Culture Clash?

I am working on a book that explores lessons learned by early adopters of EMR software (also known as EHR software in the US).  In the course of my research, I ran across an a provocative blog post by Dr. Michael Koriwchak, an EMR consultant. In this blog Dr. Koriwchak makes the argument that there is a culture clash between Health IT professionals and physicians that is impeding EMR use and adoption.  Dr. Koriwchak asserts that HIT professionals don’t appreciate that healthcare is fundamentally different from most other industries and that applying the same perspectives with regard to automating work flows ignores the importance of the doctor-patient relationship.

Physicians, according to Dr. Koriwchak, look at workflows and data as a means to an end.  They exist solely “to support and execute the decisions patients and doctors make together”.  He further contends that “the art and science of medicine defy, to some degree, traditional software structure and data capture techniques.”.  I believe that this observation regarding the challenge of applying traditional software techniques to the design of EMR software explains some of the usability criticisms that I have been hearing and blogging about over the past few months.

Dr. Koriwchak doesn’t let physicians off the hook, however, in his blog post.  He suggests that they are equally culpable in the culture clash about which he writes.  He suggests that physicians “act as if the doctor-patient relationship is so sacred as to be perfect and infallible, privileged from the need to evolve and improve.”

Do you think that there is culture clash between HIT professionals and the medical community?


2 responses to “Culture Clash?

  1. Vijit Coomara

    Mike: I agree with the “both wrong, both right statement”. Yes today there is a culture clash. IT guys should be more sensitive to the all important doctor-patient relationship and try to do our best to help the doctor in any way we can. Instead we give them some user interface which “we think is the cat’s meow”, but we are oh so offended when the doctor refuses to use it because we have in fact given him/her something that actually makes him/her less productive. IT guys need to spend their time with doctors and learn to listen and take what they say very seriously. On the other hand the doctors also need to realize that their workflow is not as special as they think. I think we will continue to clash, but as the age demographic is changing, we have better opportunities to meet in the middle.

  2. 2 points…
    1) I f you want to see a highly evolved I-technology/physician interface look at Radiology & PACS. Not only have the vendor’s verbal/visual/tactile interfaces been highly tuned, but IHE has developed comprehensive workflow models. Not perfect yet, but the current state represents the results of much effort in this area ….

    2) I am writing a whitepaper about IT service management in healthcare. To start things off, about a week ago, I posted query on a Linked-In group asking folks to suggest attributes of healthcare that make it different from other domains from the perspective of IT. To start things off and to make things a little interesting I posted a “top 10 list” but left off perhaps the most important attribute.

    The group has about 60 members, mostly from Ontario, but so far the post has yet to generate a single response (are we actually not different?). If you are interested in contributing join the group “ITIL for Healthcare” on Linked-In (disclosure – I am the manager if this group).

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