The following is a guest blog post by Sean Erreger, LCSW or @StuckonSW as some of you may know him.
It was a privilege to attend the 2018 HIMSS global conference this year. Having blogged and tweeted about Health IT for a couple of years, it was great to finally live it. By taking a deep dive, attending presentations, demoing products, and networking; I came to a greater understanding of how Health IT tackles the problems I hope to solve. From a social work perspective, I continue to be fascinated with the idea that technology can facilitate change. Getting lost in artificial intelligence, machine learning, natural language processing, and predictive analytics was easy. It was exciting to learn the landscape of solutions, amount of automation, and workflow management possible. As a care manager, I believe these tools can be incredibly impactful.
However, despite all the technology and solutions, came the reminder that Health IT is a human process. There were two presentations that argued that we can’t divorce the humanity from health information technology process. First was on the value of behavioral science and secondly a presentation on provider burnout and physician suicide.
The Value Of Behavioral Science
This was a panel presentation and discussion moderated by Dr. Amy Bucher of Mad*Pow including Dr. Heather Cole-Lewis of Johnson and Johnson, Dr. David Ahern of the FCC, and Dr. John Torous of Harvard Medical school. All experts were a part of projects related to Personal Connected Health Alliance. They asked attendees to consider the following challenges and how behavior science play a role…
— Sean Erreger, LCSW (@StuckonSW) March 7, 2018
Questions like how do we measure outcome and defining what “engagement” look like are key to how we build Health IT. Yes, things like apps and wearables are cool but how do we measure their success. This can often be a challenge. It often feels like health IT is trying to outdo each other about who is coming up with the coolest piece of technology. However, when we get down to the nuts and bolts and start to measure engagement in technology, we might not like the results…
— Sean Erreger, LCSW (@StuckonSW) March 7, 2018
This presentation reminded me that technology is not often enough. Valuing the importance of “meeting people where they are”, may not include technology at all. We have to challenge ourselves to look ethically at the evidence and ensure that digital health is something a patient may or may not want.
Technology as a Solution to Physician Burnout and Suicide
It was reassuring to know even before I got to HIMSS that suicide prevention was going to be part of the conversation. Janae Sharpe and Melissa McCool presented on physician suicide and tools to potentially prevent it. This presents another human aspect of Health IT, the clinicians that use them. The facts about physician suicide are hard to ignore…
— Max Stroud (@MMaxwellStroud) March 9, 2018
As someone who has done presentations about burnout and secondary trauma, I am acutely aware of how stressful clinical care can be. It is unclear whether technology is a cause but it is certainly a factor, even in physician suicide. The research on this complex, but to blame the paperwork demands for burnout and physician suicide is tricky. To attribute a cause to things is always a challenge but my take away is that the Health IT community might be part of the problem but the presenters made a compelling case that it should be part of the solution. That not only reducing clicks and improving workflow is needed but providing support is critical.
They talked about the need to measure “burnout” and see how the Health IT community can design technology to support those at risk. They have created a scale called the Sharp Index to try to measure physician burnout and also build technology to provide support. This seems to be striving for that right mix between measurement in the hopes of making space for human processes in a complex technology space.
Cooking The Mix Between Tech and Human Care
These presentations leave Health IT with many questions. Apps to provide a means of clinical care exist but are they working? How can we tell we are getting digital health right? How can we tell if technology is making a difference in patients’ lives? How do we define “success” of an app? Is technology having a negative impact on clinical care and clinicians themselves? If so, how do we measure that?
These questions force us to take an intentional look at how we measure outcomes but more importantly how we define them. Both presentations stressed the multi-disciplinary nature of health information technology development. That no matter what the technology, you need to ask what problem does it solve and for who? As we consider building out AI and other automation we need to keep the humanity in healthcare. So we can better care for ourselves as providers and ask what patients need in a human centered manner.
About Sean Erreger
Sean is Licensed Clinical Social Worker in New York. He is interested in technology and how it is facilitating change in a variety of areas. Within Health IT is interested in how it can include mental health, substance abuse, and information about social determinants. He can be found at his blog www.stuckonsocialwork.com.