Health care's complicated relationship with technology

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Here's a quick, amateur medical diagnosis: the health-care system is ailing when it comes to technology.

In the last six months, we've read news of remarkable medical breakthroughs: mind-controlled artificial limbs, injectable brain implants, nano-sized robots that can do colon biopsies, and more. So, from those stories it would be easy to assume that hospitals, doctors and researchers are literally on the bleeding edge of tech. And yet.

Ask your doctor to renew your prescription and chances are the request will be sent via fax to your pharmacist. Visit a specialist and, if you're lucky, the report of that visit will make it to your family doctor in a couple of weeks, on paper. Look around the receptionist area of your family physician, optometrist or dentist. You'll likely see rows and stacks of brown, colour-coded paper file folders.

Despite the availability of electronic health-care record (EHR) systems, many health-care professionals still rely on handwritten notes, despite repeated studies that show the benefits of EHR systems.

So, how can a single profession have such two polar opposite relationships with technology? MRIs and fax machines? Really?

It turns out that the frontline medical profession is driven by doctors. And doctors are human. So, they are wary of technology for exactly the same reasons most late majority and technological laggards are -- they like what they know, don't take the time to learn the new tech and, prior to experiencing it, are worried about privacy, with negative (and often wrong) ideas about the change. And, some of them use keyboards like drunk bonobos -- which actually, is a huge barrier.

Any organization that introduces new technology has to start at the top, even if the desire for change is a grassroots movement. In the case of frontline health-care, the top is doctors. If doctors don't embrace, train on, use and advocate, say, electronic health-care records, nobody else will.

To be fair to the docs, it's not all their fault. The gold rush of developing software for health care has resulted in a wide and wild variety of EHR solutions, many of which don't play nicely with each other. And, the federal government has not established clear guidelines for EHR adoption or laid out clear application program interfaces (APIs) for other vendors to follow if they want to plug their software or apps into a larger EHR system. And, some systems place security limits that make it impossible, for example, for a general practitioner to get into a hospital's computer network.

And, some of the systems have interfaces that were clearly coded by a software engineer who graduated at the top of the Design Like a Blind Klingon class. Bad design leads to frustration, training expense and abandonment. And, that's led to Canada having the lowest adoption rate of EHRs in the G7 countries.

Sometimes only attrition can solve the problem. My longtime dentist recently retired. His wife maintained careful records using an antiquated paper-based system, that worked for them, for decades. He sold his practise to two young dentists who now have a modern EHR system in place.

Other technological advances, like Fitbits and other wearables, can provide far more data than insights, data that doctors really don't know what to do with at this point. So, for them, wearables are as much a distraction as patients showing up with a diagnosis from Dr. Google.

But, all that still doesn't explain why a hospital with CT and MRI scanners still faxes prescriptions to a pharmacists. That... now that is just plain stupid.

Listen to an audio version of this column, read by the author, here.

Wayne MacPhail has been a print and online journalist for 25 years, and is a long-time writer for rabble.ca on technology and the Internet.

Photo: Amber Case/flickr

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