Healthcare IT’s Success is Truly in the Eye of the Beholder

I’ve come across few articles recently that really validate the notion that the success of healthcare IT is really in the eye of the beholder, or in some cases, the editorialized results of a study.

Take, for example, the following headlines:

“EHR Use Not Linked to Improved Diabetes Care Quality, Study Finds”
“App Improves Diabetes Management Among Teenagers, Study Finds”

I find it hard to believe that if formally connected, the second study couldn’t somehow influence the first. In other words, if a mobile health app can improve diabetes management among teenagers, shouldn’t whatever data that app is capturing transmit successfully to the teen patients’ EHRs for easy access by their doctors? And then couldn’t that doctor digest that information, picking out patterns in the patient’s behavior that is either positively or negatively impacting their diabetic condition and overall health, to better inform care protocols?

I’m taking big leaps of logic here, since the first study found that not only was there no correlation between the use of an EHR and “increased adherence to clinical guidelines for care processes and treatments,” but there was actually a “higher probability of meeting certain targets for blood pressure and A lc levels after two years” at practices without such systems. (Seems like these outcomes might be due more to end-user experience than the technology itself.)

The second study doesn’t even mention EHRs, but I wonder how many of the 20 teens participating in the study see doctors who have this type of technology, how many of those doctors know their patients are participating in the study (all I’d assume), and how many are feeding the app’s info into an EHR.

Surely if a smartphone app is helping a diabetic teenager better adhere to medication regimens, then the EHR their doctor could potentially be using would somehow tie in to better clinical outcomes. Another study to start, perhaps?

The second set of headlines that gives me pause (and kinda makes me chuckle) includes:

“Physician Use of Tablets has Nearly Doubled Since 2011”
“Not all Doctors and Nurses are Happy with an iPad in the Hospital Setting”

Neither headline surprises me. We all know that adoption of mobile health tools is growing, if not by leaps and bounds then at least steadily. It would make sense that providers are adopting tablets in relation to this. Every technology has its detractors, so of course not everyone is going to be happy with how an iPad works in a clinical setting, just as not every provider is going to want to install an EHR. I do wonder, though, how the same set of users mentioned in the second article would rate a different kind of tablet if given the opportunity to use one.

I find the first sentence to be kind of hard to believe: “It looks as if most doctors and nurses would rather not touch the iPad at work (or deal with any other kind of tablet computing).” If “most” doctors and nurses would rather have nothing to do with tablets at work, than how can physician use of tablets have doubled since last year?

So you see, the “success” of healthcare IT seems to depend on whose writing about it. I have a feeling the American Forest and Paper Association might be behind the very first one.

About the author

Jennifer Dennard

Jennifer Dennard

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

1 Comment

  • These all make sense and are not contradictory at all.

    Article 1. EHRs are poorly designed for use in the medical world, do not use structured data or clinical decision support to any major degree, and therefore decrease productivity and disrupt workflow, a setup to either decrease quality or keep quality the same.

    Article 2, a well designed app outside the EHR world will improve quality of care.

    Putting these 2 things together is being blocked by the EHR vendors. They lack interest in anything they do not make themselves and thus do not make money selling. If they were able to interoperable with external niche software, quality and productivity would go up.

    Article 3. Almost all the Docs I know love their iPads and iPhones. I believe their use is increasing logarithmically by med professionals. They use them for anything that a good app exists for. Travel, email, pubmed, reading, Internet, etc.

    Article 4. EHRs are not designed for tablets so med pros do no like using them at work to interact with these systems. When good systems are designed with iPad interfaces, doctors and RNs will embrace them.

    I understand your confusion. I remember being at a talk 2 years ago where 4 IT systems that were not EHRs were discussed in terms of how they increased quality and increased prooductivity. The conclusion of the talk was that EHRs are good. This type of subterfuge in why we are wasting 40 billion dollars putting lousy EHRs into hospitals. Where’s the outrage?

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