As most readers know, I’m a tech person by background (and literally @techguy on Twitter). It’s fair to say that I come from a tech perspective when it comes to dealing with most things in life. However, I think I’m a very reasonable tech person that understands the best solution to a problem and applies it appropriately. I’ve always loved people as much as I’ve loved tech.
I feel lucky that I’m usually able to bridge the divide between the two different worlds quite well. In fact, my favorite compliment I get is when people who’ve read my blog forever meet me in person and learn that I’m not a doctor. I’m definitely not a doctor, but I’ve always tried to write from a physician perspective. However, what is very clear to me is that the IT perspective on the world and the Healthcare perspective on the world are very different. In fact, it’s very much a clash of cultures.
The best example I’ve seen of this is in how each of these worlds (IT and Healthcare) approach failure. In the technology world, there is a culture that glorifies failure. The idea that you tried something and failed means that you’re that much closer to a solution. The tech world doesn’t see it as failure at all. The so called “failure” is just a way to rule out one of the available options. This is even true for tech startup companies. Having a failed tech startup company is almost a badge of honor that will help you get more funding for your next company.
On the other side of the world is the healthcare world which has a culture defined by their efforts to make sure that they never fail. While that’s not achievable, that’s their goal in everything they do. Look at the medical device industry regulation as a simple example of this. Look at how doctors take care of patients. As a patient, I want my doctor to try every way possible to make sure they don’t fail. The cost of failure in healthcare can mean someone loses their life. This is not something to take lightly and I’m glad that most in healthcare don’t take it lightly.
Thus we have this amazing clash of cultures. One that glorifies failure as part of the learning process and another that has deeply embedded that failure is unacceptable. You see this in every large healthcare organization. You see it even more when a young tech startup company tries to enter healthcare. It’s why so many of these young startup health companies fail to gain any traction in hospitals and healthcare.
What’s the solution? There is no easy solution. Changing culture is never a simple or quick process. However, both sides can learn from each other. The key is that we need to move away from an all or nothing approach to failure and move to a much more nuanced view of failure. Healthcare leaders need to realize that not all failure is bad, even in healthcare. Yes, there are some times when failure can never, ever be acceptable. However, there are plenty of other times where failure will not only not do any major damage, but will be an important step towards learning and growing. On the other side of the coin, tech people need to realize when something they’re doing in healthcare can not fail and realize there are plenty of situations where this is a requirement in healthcare.
Much like privacy, it’s not that avoiding failure isn’t important in healthcare. It’s extremely important, but we need to have a more nuanced and sophisticated view of when it’s important. This is not an easy balance, but not doing so will cause us to miss out on so many needed opportunities. The good part is that a great leader will have the tech people pulling for more failure and the medical people pulling for more reliability and security. We just need to bring the two together.
So that’s the difference between us! How can we introduce the freedom to fail into the healthcare world? Simulations. How do we create simulations? IT. We already have disaster drills in healthcare. We use simulators for CPR training. We need more surgery simulations, diagnostic simulations, nursing simulations, CPOE simulations, etc. Once more, we look to the aviation industry for inspiration. They require recurrent training and testing on simulators. We need to do that, too, in all our spare time.
I don’t think that we’re different. I think the culture’s of how we were educated and learned is what’s different. I don’t think we’ll change those culture’s over night, but awareness of this divide is likely the first step. Communication of perspectives is likely the second step.
It may well be that “in the technology world there is a culture that glorifies failure” in R&D, but in engineering that is not the case.
The culture that is pervasive in my organization (and in other tech companies I worked for like GE, Bechtel and Singapore Airlines), was that the result of more than one or two “tried something and failed” means you’re that much closer to the door.
I just read a post a few minutes ago a post re the “difficulties” of retiring legacy systems given that they impact patient EMRs – it certainly is difficult if the EMRs were poorly designed. The two issues are totally separate if the EMRs were well designed.
http://sparkblog.emc.com/2014/10/clinical-archiving-integrating-accessing-inactive-patient-information/#comment-69926