To care or to document, that is the question


What’s the purpose of health IT?

It may seem a bit late to be asking, but given that the evolution of IT is ongoing, it seems worth periodically revisiting the question in case, well, previous assumptions were wrong.  After all, ideas about purpose lead pretty directly to the form a piece of equipment or, in this case, software ultimately takes.

As this doctor sees it, “I am not so much a fan of technology, but what technology can do.”  He points out that, “Technology is not the goal, it is the best tool to reach many of my goals. There are two things that measure the effectiveness of a tool:

1. Is the tool the right one for the job?

2. Is the person using the tool properly?

From there he lays out criteria he thinks should be driving IT development.  Following are a few excerpts:

1. Communication over documentation
While data gets all the attention of IT vendors, health executives and government drones, it is the communication of that data that constitutes good care. One of my first goals in my new practice is to use whatever tools possible to enable that communication. Standard healthcare only allows communication in the exam room (although many patients would say that doctors are so focused on documentation that they don’t listen there either). Between office visits there is virtual silence from the patient, as if their life is not happening during that time. . .

2. Organization of data
The point of organization is to see through the extraneous to see the meaningful. It is, in essence, another part of communication. As I listen to a patient’s story, I ask questions and bring out important details they may have missed, and ignore that which I know is not significant. . . .

3. Collaboration, not ownership
The world of health IT is obsessed with something called "data ownership." This is kind of crazy, as data is information, and information is fluid. How do you “own” information? If I learn a fact, do I "own" it? If I possess a book, does that make me the owner of its ideas? The wonderful world of HIPAA and the threat of identity theft has bolstered the cause of "ownership." Unfortunately, communication of ideas is diametrically opposed to this concept. IT must not be about building walled gardens of data, but about collaborating with that data for the sake of patient care.

There’s more, including an oft-heard plug for “ease of use,” but we’ll let you read the piece in its entirety.

And then tell us what you think the primary purpose of an EHR is, and how, accordingly, it should be structured.