Electronic Health Reporter

As the excitement of the festivities continued to roil on in Chicago for the annual Healthcare Information and Management Systems Society (HIMSS) conference, and as health systems leaders merged with colleagues and partners for what is health IT’s biggest event of the year, I was not among those in attendance. As the conference opened and buzz at the show began to swell, excitement for news and new developments flowed from nearly every available channel, I was back home, far from the excitement of the show or its announcements, developments and news makers.

As health system leaders and their technology partners discussed how their solutions could make care better, engage patients more effectively and lead to better outcomes, greater efficiencies and higher quality care, my wife and I were in the center of the care universe in the heart of our local hospital where I was helping her through the delivery of our second child. Though the process was relatively straight forward and was done very quickly, the experience made me realize several things about healthcare technology from the patient’s perspective.

The first thing is that no matter how important we claim the technology used in the care setting to be, it matters little to those receiving care. For those receiving care, they want and need a seamless process where they have immediate access, without a wall of technology between them, to their care providers whether that’s a nurse, physician or some other support personnel. Patients, at the point of care, don’t want to face the burdens of interacting with the technology their caregivers are concerned with, but we as patients want their full attention. If patients must break through a fourth wall of technology, as I’ve seen to be the case on more than one occasion, the care staff, and more importantly, the health system, has failed the patient.

Secondly, patient engagement is more than a portal or access to one. And while patient engagement means different things to different provider types – like ambulatory vs. in-patient –the patient is still at the heart of the care, not the technology. Those who believe that technology can solve the patient engagement ills are wrong, and likely are failing to truly engage patients because they believe the myth that it can. Perhaps meaningful use has bastardized the term “patient engagement,” but it’s a sad thing when the entirety of that conversation centers around some form of technology or device. The irony of an event like HIMSS, where most of health’s relevant vendors clamor to meet with health system leaders, is that the buzz is built to surround the movement of the patient.  The patient is at the heart of care, not technology or some bolt-on software solution.

We, patients, have been at the heart of care since the existence of healthcare; technology is an infant at play here. Let’s not forget that.

So, while the parties raged in Chicago and deals were struck, I don’t feel like I missed out on the most important healthcare event of the year. On the contrary, this year I actually felt like I was at the center of the healthcare world, in a hospital room as my wife underwent what’s still considered a fairly big medical procedure. While there, I witnessed the overt advertising of a single sign-on solution (Imprivata) being used on a number of screens, the branding screaming to those who cared look. I also heard numerous sentiments of displeasure with the hospital’s Cerner EHR, and while the use of it is required by the care staff and reasons for the technology are obvious, its use seems to have made the nurse’s lives all the more difficult. However, the hand-held devices that nurses carried with them from room to room to input patient information into the patient record seemed very effective and non-intrusive, compared to laptops or tablets as I’ve seen others use.

It is worth noting that the electronic health record did prevent a possible adverse medical reaction from occurring when a drug prescribed to my wife was listed in the EHR as troublesome for her, from a previous visit to the hospital.

Most beneficial from my time in hospital while HIMSS was taking place, when thousands of others were shaking hands and scanning name badges, was experiencing the care of the nursing staff whom overwhelmingly bear the burden of the patient engaging technology their bosses, most of who were not in the hospital rooms but in Chicago thousands of miles away, are buying to provide better care. So while I understand the need for the technology and its use in healthcare and the overwhelming opportunity it creates to enhance the experience, and possibly help save lives, let’s not forget chants about “patient engagement” and improved care experiences are more than rallying cries for organizations like HIMSS to rally around and descriptors for vendors to sell more technology.

Experiencing first hand once again the effects of healthcare technology from the hospital room, ironically, while HIMSS was ongoing provided me an interesting juxtaposition to the reality of things versus the “truth” found in the industry’s marketing speak.

A stark reality is that the patient, and his or her engagement, is at the heart of healthcare. Despite the technology available or implemented and all of our conversation about how it is winning the day, technology can only make the experiences with patients better if it doesn’t get in the way of care, but rather enhance it.

As much as we say this is the case, I fear the reality of the situation is quite different. Technology enhancing care, as is often explained by the cheerleaders and carnival barkers at HIMSS, seems different from the reality found in hospital rooms throughout this country.