Digital Doctoring

The Boston Globe
March 29, 2007

NY NOW, the stories are legion.  Physicians at a California hospital rebel against a new computer system for ordering prescriptions and laboratory tests, forcing it to be shut down.  In the Southeast, doctors at an acute care facility bypass the new computer system by seeking assignments on  wards that have not been computerized.  And in a suburban Boston hospital, the chief of surgery stalks into the CEO's office and, referring to a brand new medical computer system, demands, "Rip it out!"

Why are new technologies resisted by the very professionals they are designed to help, and why is there such aversion to systems designed to improve care, reduce medical errors, and lower medical costs? The answer is training.

A generation ago, doctors were taught that they were all-knowing healers whose judgment was sacrosanct.  But today, there's simply too much to know.  With the overwhelming advancement of innovative drugs and procedures, doctoring has moved from an individual endeavor to a team effort, and it is technology that binds the team together.

... In general, these technologies let computers do what they do best -- collect and disseminate data -- while letting doctors do the doctoring.

The benefits, both fiscal and medical, are potentially vast.  A study by the New England Healthcare Institute and the Massachusetts Technology Collaborative found that spending $210 million to install computer systems for ordering prescriptions electronically in all Massachusetts hospitals would reap savings of $275 million.  As value added, the Computer Physician Order Entry system also reduces medication errors and lowers the length of hospital stays.  Similar cost-benefit dynamics are at play with other medical  technologies ranging from basic electronic records all the way to the remote monitoring of intensive care patients in "tele-ICUs" 

...New technologies force us to change the way we were taught to treat patients... When major new information technology systems are introduced into a hospital, among the keys to success are training and technical assistance for doctors, peer pressure, and reverse-mentoring from younger, more receptive colleagues, and, if necessary, financial incentives to gain compliance. 

Link to Full Article: http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/03/29/digital_doctoring/