DOCtalk by Dr. Gregg 10/28/12

If It Was a Wonderful Life

Whoa … it was seriously disturbing hearing that voice coming from Summer, our beautiful, sweet, genteel Golden Doodle. She’s not prone to any noisemaking, rarely even a bark, no less the raspy, smoke-ravaged voice of my old spiritualist and now occasional spirit guide, Madame Blavatsky. You can imagine my non-intoxicated – honest! – surprise. (She’s a bit of a mischievous disembodied soul, reading my thoughts without permission, popping into my reality without invitation.)

“So,” she starts in her husky Ukrainian, semi-masculine voice, “you vant to see vhat the vorld vould be like if HIT had started vith a plan, a grand design, huh?”

I nodded at Summer, remembering how I had recently wondered just such a “what if.” Still, I was somewhat uncertain if this was a waking ghostly emanation or some mini-stroke, epileptiform fantasy my neural synapses were concocting. I was pretty sure Summer hadn’t been raised anywhere near Odessa, thus the accent seemed to clinch the fact that this wasn’t really my dog speaking. The sound of the football game on the TV semi-assured me that I was still sitting on my couch. The cool feel of the Pepsi in my hand seemed to imply that I wasn’t comatose or stroking out.

“So, you vant to see vhat could be, huh? You vant to know vhat you’re missing? Well, so be it, my little Solnyshko,” she semi-growled.

With a wag of her tale and a blink of my eyes, I was suddenly standing at a work counter in my office, looking down at a tablet computer. But it was unlike anything I’d ever seen…

The user interface was gorgeous! Everything I needed was right there, without extraneous clutter. Everything I wanted was accessible, without extravagant effort. Everything was clean and friendly and visually pleasing … and it made sense, stupid simple sense.

I touched the tablet and useable items popped in and out without screen refreshes or wasted motions. I wanted a lab result: it was a click away. I needed to check an old note: pop, there it was, without covering my current view. I wanted to track BMI and blood pressure trends: tap, click, there it was in beautiful Technicolor clarity.

Somehow I knew I needed to see a specialist’s consult note. I also somehow knew it wasn’t necessary for it to have been “sent” to me; it was available in the cloud. I tapped the referral reference and, blip, there was the note, pulled from the common HIE platform. Even better, it was easy to read – not too short, not too long; it was plain old Goldilocks “just right.” I could easily see the provider’s overall intent and just as easily drill down to see the deeper story details. I could sense the deep connection to the core values around which all had been built, the grand design of HIT grandfather, Larry Weed. It was SOAP note structure and straightforwardness empowered by well-designed HIT “steroids.”

I tapped the screen to place an order and was suddenly sucked through a Matrix-esque screen of descending green code, going deep into the digital bowels of the system. There I saw the pure simplicity of the surface world replaced by complex yet smart digital wizardry. Systems spoke with each other in incessant ones and zeroes, but they all spoke one seamless language. I could sense there was no interface mumbo jumbo and no translational transgressions; everything was stupid smart. It was designed from the ground up to work as one system. Every section of the system complemented every other section. Data flowed like grease through a goose.

Speaking of waterfowl, I had the distinct impression that I was looking at the feet of a duck paddling furiously under the water while knowing that on the surface of this medical computer network “pond,” the EHR “duck” appeared to be gliding effortlessly across the clear, still surface. It was HIT as it should be. It all worked. It was all connected. It was all accessible. And, it was all absolutely wonderful!

The sound of my cell phone yanked me from my reverie. I was pulled, unwillingly, back through the Matrixian coded channels to current reality. It was an after-hours call from a distressed parent.

I tried to pull up their child’s record on my home PC, but something had failed and I was unable to connect with my EHR server. It was a moot issue anyway, as this parent’s question revolved around the psychologist’s recommendations from their evaluation two weeks ago and I just knew I wouldn’t have access to any such documentation – not now and possibly not in the foreseeable future.

As I did my best to answer this pleasant parent’s anxious queries based upon the limited information to which I had access, I looked over at Summer and could swear she winked at me as I saw a white lotus reflected in her eye. Blavatsky…er…Summer, even appeared to be smirking as she rasped one last vocalization: “George Bailey you’re not, Solnyshko, but vhat’re you gonna do?”

From the trenches…

“After enlightenment, the laundry.” – Zen proverb

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of Today! exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).