We know why we devote our careers to the implementation and effective use of health care information technology.
Care quality is too variable. Medical costs are too high. Many people cannot get access to the care they need. There are too many medical errors. Patient service in some of our organizations is appalling.
We believe, and rightfully so, that information technology can help to solve many of these problems. Computerized physician order entry, the electronic health record, mobile technologies and health information exchanges can make a difference.
When we talk about these problems in health care and the role of information technology, we usually talk in the abstract. We talk about processes, organizational change, advances in technology and application capabilities. We observe with alarm the growing burden of chronic disease. We discuss challenges in engaging physicians. We assess a vendor’s solutions.
This abstract discussion can lead us to forget that there are real people who deliver care.
My father, George Glaser, was a bright, engaging, accomplished and witty man. He had an exceptional sense of humor.
He died recently.
He had a form of dementia (Lewy body disease) that results from a combination of Alzheimer’s and Parkinson’s symptoms. On top of this, he had a series of other medical maladies such as kidney stones, spinal cord degeneration and a broken wrist from a recent fall.
The loss of those you love is inevitable. I know that. You know that. My dad knew that. Sometimes the loss is sudden. And sometimes, as is the case with my father, the loss occurs over years. The father I knew slowly vanished. While we all know that it is inevitable, loss is filled with sadness and grief and renewed desire to love those who are close to us because we will, some day, lose many of them, too.
During his last year, I had many encounters with the health care delivery system. I took my father to get a CT scan of his lower abdomen. MRI films of his back were fetched from a local hospital. We took him to an orthopedic surgeon’s office to assess the mending of his wrist. There were meetings with physical and occupational therapists to discuss his care needs. I sat with him and a physician assistant to review his overall care plan.
I have lost track of the number of health care tests, discussions and visits that filled his final months.
I met many exceptional people. The physician assistant, a former corpsman with the Marines, had superb assessment skills; he also called every night to check in on my father. The physical and occupational therapists demonstrated an impressive set of skills and empathy. The orderly who helped me to lift my father into the CT scan showed genuine kindness and gentleness. The receptionist at the neurology clinic had become a friend of my father’s and was delighted to see him when we dropped off his MRI films. The orthopedic surgeon, who seemed to be one of those surgeons to the stars, was patient in his explanation of the X-ray results that showed good progress in the healing of my father’s wrist.
I have lost track of the number of health care professionals I met. But all of them were superb.
The Foundation of Medical Care
These professionals reminded me that great medical care sits on a foundation of great professionals who are real people. Medical care is not like buying groceries or going to the dry cleaners. Medical care is a human undertaking. Medical care often brings with it deep emotions of love, loss and duty. And while the technical performance of medicine is important (I want the best physical therapist and I want efficient care processes), perhaps equally important is the human performance of medicine — being gentle, interested, patient, respectful and empathetic.
Our job in the health care information technology field is often directed to improving the ability of health care professionals to enhance the technical performance of medicine. We implement systems that track health maintenance tasks, suggest which medications to order or improve the accessibility of test results. But our job is also to enhance the human performance of medicine. To the degree that we help to remove the hassle from health care delivery and reduce the difficulty of getting basic operations to work well, we help those professionals devote more time to the human performance of medicine and to be less frazzled as they do so.
In the months and years ahead, as I sit in meetings about product plans and the status of implementations, I will have in the back of my mind the images of those people who took care of my father. And I will be asking myself if this work, and the way we are doing it, is likely to help those who are caring for people like my father to be better at both the technical and human performance of care.
We should always remind ourselves that we provide systems for real people, not “users.” We should take a day or an afternoon and shadow a physician, nurse or therapist and really see and feel the technical and human performance of medicine. We should close our eyes and remember the health care received by someone close to us and the terrific health care professionals whom we met.
I love you, Dad.
And I do what I do to help those who provide care to people like you.
John Glaser, Ph.D., is a senior vice president of Cerner Corp., headquartered in Kansas City, Mo. He is also a regular contributor to H&HN Daily.