Industries are constantly being revolutionized by the implementation of new technologies which aim to improve efficiency and deliver consumer satisfaction—especially within healthcare. As we progress into the digital age, healthcare professionals are beginning to rely more heavily on technology to diagnose a wide range of complex illnesses. Such technologies are constantly being developed and deployed in clinical settings in an effort to better treat and care for the ill. While such innovation has led to great advancements in medicine and improved health outcomes, not every piece of new technology has been a home run. In fact, many providers and experts within the industry have a laundry list of complaints about new technologies and the barriers these technologies produce [4].
There are a lot of fears that surround the notion that technology can replace human providers completely at the cost of patient doctor relationships. “Patients generally feel more at ease with their situation and have more confidence in the diagnosis if they have a personal relationship with the provider,” says Paul Cooper, CIO of consumer data analysis group at NRC Health. “If you are on a first-name basis with a provider and they know who you are, then the news they provide is going to be taken so much better as opposed to situations where the provider knows you from a technical perspective — they know your chart, your lab work, but in the five minutes they’re in the room with you they’re mostly looking at those data points and not engaging with you as a person. They may have a ton of information about you in the EHR [Electronic Health Record], but if they don’t stop and pause to get to know you as a person, I think their impact is going to be less. The patient is going to leave that visit with a less positive perspective” [5]. The main issue with the reliance on electronic health records is not with the data itself, but the time burden that such technologies place on clinicians making it difficult for them to have ample patient interaction.
Studies have shown that for every one hour spent face to face with a patient, a physician spends two hours facing the screen of a computer dealing with EHRs. Ironically, the same technology created to better patient experience is worsening it by distancing patients and providers. This causes concern for burnout among physicians, as they did not go to medical school to deal with technology, but to pursue their passion for healthcare.
Besides the issue of lessened interaction, the safety and security of EHRs come into question. If doctors are reliant on such systems to tell them about their patients, what happens if such technology goes away? EHRs centralize all patient and care data into one platform, which makes them vital to the function of a provider's role. However, we hear of technology failing to perform too often to place our full trust in it, especially within a healthcare setting. “The slightest troubles with completely digital healthcare systems can severely hinder a doctor's ability to provide quality care for their patient,” said Dr. Peter Kilbridge in Computer CrashLessons from a System Failure [3]. Such service interruptions can not only be stressful for providers, but potentially deadly for patients. An example of a complete system failure occurred in 2002 at Beth Israel Deaconess Medical Center in Boston, where the whole hospital crashed due to an overload of information being inputted into the records system. The hospital operated by pen and paper until the issue was resolved and made providers truly realize how reliant their jobs were on such technology, raising many doubts. “The increasing reliance of hospitals on information technology raises larger questions about the vulnerability of clinical and administrative operations to technological disruption,” said CIO John Halamka [2]. Worse than a system failure, a data breach of EHRs can expose some of the most personal and intimate details of a patient's life, and trusting technology to keep it safe is not entirely reasonable. You cannot have a conversation about health informatics without ensuring data security. Hospital executives, boards, and information-systems departments must engage in an ongoing process of assessing the risks, costs, and benefits of information technology, while also structuring investment and management decisions accordingly.
The inefficiencies of healthcare information technology remind us why it is important to always build upon patient and provider relationships and keep healthcare as human as possible. While the use of these systems can be beneficial, doctors must make an effort to get to know their patients outside of their charts, and patients must advocate for the privacy and security of their information. Health care information technology should not be central to how we provide and receive care, but be a useful tool that aids in the experience.
References
1. Sittig, D. F., Wright, A., Coiera, E., Magrabi, F., Ratwani, R., Bates, D. W., & Singh, H. (2020). Current challenges in health information technology– related patient safety. Health Informatics Journal, 181–189. https://doi.org/10.1177/1460458218814893
2. Hersh W. Health Care Information Technology: Progress and Barriers. JAMA. 2004;292(18):2273–2274. doi:10.1001/jama.292.18.2273
3. Kilbridge P. (2003). Computer crash--lessons from a system failure. The New England journal of medicine, 348(10), 881–882. https://doi.org/10.1056/NEJMp030010
4. Culyer A. J. (2021). "Perspectives" in Health Technology Assessment. AMA journal of ethics, 23(8), E619–E623. https://doi.org/10.1001/amajethics.2021.619
5. Choe, E. K., Duarte, M. E., Suh, H., Pratt, W., & Kientz, J. A. (2019). Communicating Bad News: Insights for the Design of Consumer Health Technologies. JMIR human factors, 6(2), e8885. https://doi.org/10.2196/humanfactors.8885
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