The 2037 Advanced Health Information Technology Conclave
The following is a verbatim transcript from the 2037 worldwide conclave for Advanced Health Information Technology in London (purveyed from the future by my old pal and favorite spirit guide, Madam Blavatsky):
Moderator: Welcome, all, to the twenty-first annual Advanced Health Information Technology Conclave. We’re excited to have such a wonderful attendance. This shows that HIT is now truly, as our acronym says, “A HIT.” Today, we’re honored to have the grandfather of all advanced HIT with us to give the conclave’s Grand Keynote address … Dr. Harry Schmeed!
(Applause, applause, applause)
Moderator: As you all know, Dr. Schmeed was talking health information technology before most of you were born. Thanks to the recent progress in genomics and bioengineering, he’s still with us today, and still a powerhouse in the industry at the wonderful age of 114! It’s quite the honor to have him here, so, without further ado … ladies and gentlemen, please welcome … DOCTOR HARRY SCHMEED!!!
(Applause, applause, applause … standing applause)
Dr. Schmeed: Thank you, thank you. That’s so very kind of y’all. Please … be seated, everyone. I haven’t had such a warm reception since my cheapo replacement smart-pants battery ignited my back pocket.
Dr. Schmeed: It’s so very gratifying to look out on this sea of geeky faces – so pale and so wonderfully nerdy in your old-style Google Glasses, mud-styled hairdos, and sharp line ups. Isn’t it amazing how geekdom has taken control of the world?!
Dr. Schmeed: Just a little background to start. When I first began studying ways to make healthcare smarter, I noted one very important thing: so much of what healthcare providers do is repetitive. They see the same type problems again and again, they document the same things time after time, and they calculate the same equations repeatedly, like a dog chasin’ its tail. This was when very few people had even heard of a personal computer – and when most of you were just chocolate bars in your daddy’s back pockets.
(Little chuckles, little looks of “Huh?”)
Dr. Schmeed: My early undergrad experience at MIT gave me insight into computer systems far beyond what most anyone else in healthcare – at the time – had experienced. Now it seems that computer nerds are as common in healthcare as V.D. in a bordello …
(Scattered snickering, scattered slight gasps)
Dr. Schmeed: You’ll have to pardon my somewhat colorful, sorta euphemistic style. I‘m from Texas and we were raised with some real timbre to our tongues. My mama taught me well; she was a serious chin musician. She could turn out more weasel word turns of phrase in one sentence … enough to make any Washington politician go frog-green with envy. I’ll try to keep my tongue toned down for all you youngsters who were raised on concrete, but you’ll pardon me if some country coinage comes through the chow slot now and again.
Anyway, back to the early days. It sure seemed to me that all this repetitious work docs and nurses were doing back then was just beef gravy for computer capabilities. Why couldn’t all those laborious chores that didn’t really contribute directly to diagnostic inquiries and medical decision-making be shunted off to the ones and zeroes of computers allowing providers to focus more cleanly on care?
Seemed as natural a concept to me then as having snap in your garters. What I didn’t know was how much trouble it might muster to digitize all these processes and make them work within the confines of the world of healthcare – a world with more rules than a Saturday night dance and more silos than all the granaries from Odessa to Omaha.
We couldn’t just take computers – what we all now call “information technology” – and tie them into healthcare with a simple running stitch; it was far too messy and convoluted. It needed some fancy cross stiches and even some embroidery. We needed to make it smart, so that it worked within the fences of the healthcare barnyard without getting the neighbor’s tail all up. Thus was born the concept of “health information technology.”
To say the least, we’ve been straining from the get go. We had to pass some pretty large … um, hurdles … before we got on track, but once we did the value of what we started was pretty danged apparent. Back then, and into the early part of this century, we all though our HIT was pretty smart. Looking back, I’d say most of it was [using little air quotes for emphasis] “Smart HIT” – if you get my little acronymic drift.
(Scattered chuckles and guffaws)
Dr. Schmeed: We’ve moved on, from smart HIT to today’s truly advanced HIT. And I can tell you, it’s been a helluva ride on this bucking bronc, but well worth the backache. We’ve learned a lot. But there’s one thing that’s always rung true, one concept that helped me, and all of us, keep things in perspective as we’ve ambled – and often stumbled – along this long HIT path. My mama used to say it best: “You can’t expect a cat to bark or a whale to walk.” In other words, you shouldn’t expect things to be or act differently than what they are, or than what they’re designed to be. You need to design for real needs, for real people, in ways that don’t force unrealistic change. Design in ways that take into account the true nature of things … and especially of people.
My one prayer, my one wish for you all, is that you learn and respect the most important lesson that has consistently helped us as we eked along from “smart HIT” to “advanced HIT” – from that less pretty acronym to today’s more mixed-company-acceptable version. And that lesson is: “Don’t expect a cat to bark or a whale to walk, but if you do it right, you can expect HIT to be A HIT.” Thank you.
(Resounding applause, feet-stomping, and cheers)
From the trenches…
“Don’t expect a cat to bark.” – Soda Pop Man
Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership.