Go Willingly or Be Forced Into the Digital Age, Doctor

Physician's Money Digest, May 2007, Volume 14, Issue 5

Digital images integrated into electronic health records; robotic digital doctors; digital pharmaceutical vending machines—the Digital Age has arrived in full force. Digital information sharing has allowed the care-giving part of the job to be just that—care giving—by minimizing cumbersome and time-consuming tasks. Information technology offers incalculable opportunities to improve patient care while positively addressing business issues. Tools of innovation like wide-area outdoor wireless laptops, voice over Internet protocol, radio frequency identification, among many other technologies, allow information to be disseminated quickly and easily at the critical point of care. It has become increasingly clear that modern health care delivery is an information business, not just a people business, operating in a society increasingly dependent on immediate gratification.

The Norm vs the New

To fully appreciate the potential benefits of a digital hospital, it is important to recognize the traditional health care information process for what it is: an endless flood of paperwork. Aides logging vital signs, medical associates manually posting lab and test results, nurses hand-chronicling patient progress, and doctors scribbling notes and prescriptions while nurses scramble to clarify them, all contribute to the overwhelming paper pileups. Cumbersome x-rays are physically filed in vault-size filing rooms, and other types of medical information are housed elsewhere throughout the doctor’s office or hospital. Digital technologies require a complete reversal of traditional health care practices and processes. For example, the “chart” has been the norm for decades, despite being inefficient, difficult to retrieve, and leaving too much to chance. In the digital world, wireless laptop Lifebooks pull together all of the digitized pieces of information—vital signs, physicians’ notations, lab and test results, prescription histories, x-rays—and package them as repositories for realtime, enterprise-wide electronic data delivery.

Expanding Your Reach

Also being used by physicians in digital health care facilities are Mr. Rounder robots equipped with a video screen and two-way video capability. With these, a physician can activate the robot remotely to conduct virtual visits and videoconferences with patients, log on from the operating room to check on a patient in recovery, and make decisions remotely for those every-second-counts conditions. Seemingly whimsical, space age, robotic “digital docs” allow a doctor to be two places at once. Portable computers put real-time, comprehensive records at or near the examination room or the patient’s bedside. Digital drug order-entry systems enable physicians to write prescriptions directly to a pharmacy. Collectively, these technologies can combat human error and drug interaction problems that cost approximately 7000 Americans lives each year, according to the National Academy of Sciences Institute of Medicine.

Jumping on the Digital Bandwagon

There are doctors who have been quick to advocate a shift toward digital technology in the interest of increased productivity and quality care. The new generation of doctors is graduating from medical school with a high level of comfort with these evolving technologies. But, there appears to be an equal number of doctors who have been reluctant or opposed to a fully digitized system. Resistance is most common among established doctors in private practice and independent of hospitals. While the hospital nurses are employed directly by the hospital and are required to adhere to process mandates, independent physicians are not required to embrace a new way of conducting business. And the capital required to participate in the Digital Age is mind-boggling. Clearly, E-health is knocking at the medical industry’s door. Only time will tell which doctors will answer that call, and how. A best guess is that some will follow the early pioneers willingly and enthusiastically; many will enter with guarded anticipation; and others will be dragged into the Digital Age without a choice.

Doctor Dennis Irvine is president and CEO of Houston-based Irvine Team (http://www.irvineteam.com) with extensive experience in the commercial design and construction industry. Irvine Team has been involved in the design and construction of several Houstonarea digital projects totaling more than $100 million. This article has been reprinted with permission from the Irvine Team.