Editorial from Inside Healthcare Computing

[rninformatics, DNP, RN]

See below - Good Editorial. Do YOU think he makes a good point?

The following editorial by Inside Healthcare Computing Executive Editor Tim Dotson appeared in the July 12 issue. In it, he encourages hospitals to invest a chunk of their IT budgets in technologies that go beyond their own walls and into the community.

We've heard it repeatedly from a variety of public health studies, including one from last week. The U.S. leads the world in healthcare spending, but its citizens are less healthy.

Healthcare providers aren't to blame. The U.S. excels at delivering interventional, episodic treatments and accurate diagnoses. If you have a medical problem and a valid insurance card, this is the place to be.

Hugely expensive healthcare IT helps providers deliver those treatment episodes with some degree of efficiency and continuity. Its impact is less dramatic on societal "health" like these studies measure, however.

Hospitals patch people up and send them back into their unhealthy environments, fully expecting to see them again soon.

In that regard, healthcare IT is really just the back-office systems that hospitals use. They may, like a hotel's room management system, make a guest's stay more pleasant (and profitable), but they have little impact on their lives once they've checked out.

Healthcare is local and hospitals are its recognized experts. If hospitals really mean it when they say they want to improve the health of the communities they serve, they should invest some tiny chunk of their IT budgets on technologies that go beyond their own walls (where the U.S. leads the world) and into the community (where it lags).

Some examples of this might be:

- Facilitating chronic condition support via social networking.

- Providing online consultations.

- Offering telemedicine services to groups that support migrant workers, the homeless, and the uninsured.

- Using technology to connect uninsured, non-emergent ED patients to private and public alternatives.

- Offering cell phone reminders and tips to improve health and increase compliance.

- Finding ways to use technology to improve prenatal care and reduce infant mortality.

- Offering video health advice via the Web and cell phone.

- Providing technology support to free clinics.

Other organizations offer some of these services, so local needs vary. When it comes to healthcare technology, however, hospitals have more knowledge than anybody. The technical creativity and expertise housed in the average hospital's IT cube farm could make some of these projects happen in no time.

That's a different way of thinking for the average hospital that's run like a business and not a community service. Margins are generated by service delivery, not health. There's no ROI for hospitals to develop IT-powered public health services, so it's easy to pass the buck to IT-illiterate social agencies.

That's too bad, because hospital IT people would love working on projects like this. Instead of being mired in ongoing maintenance and multi-year implementation of systems that nobody wants to use, these simple projects could create observable change in the community.

It's been said that character is who you are when nobody's looking. It might also be said that health improvement is what hospitals do when nobody's paying. If we're going to move the needle on our health rankings, hospitals should take the lead in rolling out technology that helps people, not just patients.

Copyright 2010, Algonquin Professional Publishing

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[Mijourney]

I think hospitals moving in the direction that the author recommends is going to require a sea change in mentality. Health care delivery has been done one way for so long that several generations of the public and providers will have to pass through before anything implemented by hospital IT specialists catches on. That's just my opinion, though.

[Mission]

The teaching hospital that my nursing school is affiliated with is moving in this direction. Progress has been slow mainly because, as the author stated, I don't think they hospital has figured out how to make/save money with this.

I disagree that a lot of these projects can be handled by regular hospital IT. Applications aimed at patients require a knowledge of consumer health issues, cultural competency, and literacy issues that I think most IT staff would not consider. The projects (in the literature) that have done successfully required a team of providers, developers, public health, patient education, and informatics specialists and were often done as a part of community based participatory research projects. Just because someone works in a hospital IT department doesn't make them a health (nursing/biomedical/public health/etc) informaticist, and I think that is the key person needed to make this type of project successful, the person who can translate the user needs into the technical requirement.