There are many philosophical, cultural and even language barriers that exist between the medical and information technology worlds and bridging this gap with the ultimate aim of improving healthcare is one of the primary challenges faced by both camps. Case in point, the term “bleeding edge” doubtless means something drastically different to a Chief Information Officer than it would to say a Chief Medical Officer and I expect there are a number of other examples that would arise when and wherever the two worlds intersect.
Can Geeks learn to think like Doctors?
The value of evidenced based medicine is very much universally accepted by clinicians when considering new methods of treatment or patient care however in the IT world this sort of methodology is far from common place.
One must conclude that a clinician who accepts the value of evidence based medicine will clearly not introduce a new medical treatment into her practice without fully exploring the supporting evidence. She would therefore also likely apply such techniques when considering the adoption of a new application, technology, device etc. into her practice, department or even workflow as well.
Why then are we as IT folks surprised when clinicians rebel against us mucking about in their affairs without due process?
The opportunity for evidence based HIT
The adoption of some of the aspects of an evidenced based methodology by IT could in fact be the key to the successful introduction of new technologies, devices and processes into the world of Healthcare Technology. Few IT shops, vendors and consultants have been willing or able to make the intellectual leap or commitment; yet it is truly not an insurmountable barrier as much as it is an extraordinary opportunity.
The overall evidence based methodology is quite simple really. The steps include:
1. Formulate a sensible, focused clinical question.
2. Search the medical literature for evidence related to the focused, clinical question.
3. Rate the quality of the available studies.
4. Apply the evidence to a particular patient or clinical situation.
5. Assess outcomes of decisions.
Hey IT, you’re really doing it already anyway!
While the ideas of “evidence based” methodologies seem foreign to many in IT, they really shouldn’t be. Regardless of our profession, we are all “busy” people and resist any form of change to our work flow initially even if we intellectually understand that it will more than likely benefit us greatly in the future we naturally emotionally resist change as it introduces risk.
As busy professionals, we either don’t have the time, patience or both to study, implement, test and then normalize new technologies, devices, business processes and generally do so only under great duress only to look back six months later and wonder how we ever lived without the new thing.
Clinicians are fundamentally no different than IT folks when it comes to resisting change and are clearly not technophobic; they simply have a job to do and lot’s of it. While already stretched beyond human capacities to deliver quality care to never ending waves of patients, the thought of taking a half day out to learn how to use a application or device let alone three months to integrate a new system must seem either frightening or even absurd to clinicians, while perfectly rational to IT.
Therefore I believe there is great value in the study of the evidence based methodology and how it is applied by clinician as well as how these ideas can be adapted by the information technology industry all working towards greater collaboration and success in the world of HIT.
Evidence based Healthcare Technology is already beginning to take shape
What got me thinking about this topic was a post on Science Roll citing Dean Giustini’s work in evidence based Web 2.0.
He has recently defined what evidence-based web 2.0 means:
Evidence-based web 2.0 (EBW2) is the integration of best evidence of social software use in promoting effective time/information management skills in the digital age. In addition to alloting time for experimentation, heuristics and ‘play’, librarians and information specialists will also want to systematically evaluate EBW2 and build a good evidence-base for the future effective application of web 2.0 tools.
And in true Web 2.0 fashion Dean has set up the UBC HealthLib-Wiki to explore this topic among others related to the subject such as: Evidence based Healthcare and Applie iPhone’s for Physicians.
This is both an excellent idea as well as an excellent resource and I would encourage my colleagues in the IT camp to explore some of the content the UBC HealthLib-Wiki has to offer.
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