Health IT Adoption Challenges

One of my favourite sources of information on the health IT market is HISTalk, particularly their daily round-up of health IT news.  In this morning’s summary, the editors cited Dr. Robert Pearl, CEO of the Permanente Medical Group,  and his reasons why health IT is not “widely embraced”:

  1. Developers focus on doing something with a technology they like rather than trying to solve user problems, such as jumping on the wearables bandwagon despite a lack of evidence that they affect outcomes.
  2. Doctors, hospitals, insurance companies, and patients all feel that someone else should pay for technology they use.
  3. Poorly designed or implemented technology gets in the way of the physician-patient encounter.
  4. EHRs provide clinical value, but slow physicians down.
  5. Doctors don’t understand the healthcare consumerism movement and see technology as impersonal rather than empowering.

The editors also offered their own thoughts on this topic, citing the following impediments to health IT adoption:

  1. People embrace technology that helps them do what they want to do. Most healthcare technology helps users do things they hate doing, like recording pointless documentation and providing information that someone else thinks is important.
  2. Technologists assume every activity can be improved by the use of technology. Medicine is part science, part art, and technology doesn’t always have a positive influence on the “art” part.
  3. Healthcare IT people are not good at user interface design and vendors don’t challenge each other to make the user experience better. Insensitive vendors can be as patronizing to their physician users as insensitive physicians can be to their patients.
  4. Technology decisions are often made by non-clinicians who are more interested in system architecture (reliability, supportability, affordability, robustness, interoperability) than the user experience, especially when those users don’t really have a choice anyway.
  5. Hospital technology is built to enforce rules and impose authority rather than to allow exploration and individual choice. Every IT implementation is chartered with the intention of increasing corporate control and enforcing rules created by non-clinicians. That’s not exactly a formula for delighting users.

What are your thoughts?  Do any of these reasons ring true for you?  Would you challenge any of them as incorrect?  Do you have any reasons of your own to add?

Mike

3 responses to “Health IT Adoption Challenges

  1. Interesting. He has captured what you and I have been trying to convey over the past 10 years. We need to build on these type of comments that come with experience to highlight what to do to increase success.

    Bill

  2. One thing that strikes me as I read this is that on the Consumer Internet, crappy sites by and large get usurped by better designed sites. Whereas in Healthcare, systems are largely foisted upon users and those users then have to live with them for years, often decades. Why is that? What’s the difference between these two realms?

    I think the difference is interoperability and data mobility. Imagine a world where the healthcare data repository can be accessed by any vendor using standardized interfaces–where the User Experience is decoupled from the data behind it. In this world, it would be relatively inexpensive to replace a crappy healthcare UI with a brilliant one. But so long as our healthcare data is locked up behind proprietary systems, our healthcare providers will continue to be shackled to their crappy systems.

    I agree with you that technology isn’t the solution per sa. I do, however, believe that interoperability and data mobility have a huge impact on whether innovation is even possible. Interoperability and data mobility are technological characteristics. Microsoft tried to fight the standards-based Internet and lost. The future belongs to those who pursue simple, open, interoperabile technical healthcare standards.

    Wherever valuable data is accessible through simple open standards, innovation will flourish.

    • Ken,
      Thanks for your thoughtful reply. I fully agree with you … I think that interoperability and data mobility are a key issue that needs to be addressed. Did you read my blog post on platforms? I think that EMRs will morph into platforms that support interchangeable apps that address the needs of specific audiences.

      Mike

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