Healthcare is full of workarounds. Many of them show an extreme amount of creativity. It’s just unfortunate that all of those creative juices are spent on workarounds and not the core problems. While many of the health IT workarounds out there are about health IT people doing what they need to in order to get stuff done, there has to be a better way.
A little while back, Janae Sharp asked for people to share examples when health IT was used as a workaround rather than solving the root workflow or data entry problem. The answers she got were insightful (and it seems a little cathartic for some). Here are a few that stood out to me.
Exhibit 1: Healthcare Delivery Networks refusing to connect via interface or share data easily so you instead configure your multifunction printers to scan to fax to accommodate the numerous medical records and data requests……..
— Aaron Miri (@AaronMiri) May 14, 2019
Yep. Aaron is spot on. This was my response.
You could have just said See: Fax.
— John Lynn (@techguy) May 14, 2019
Aaron Mier, CIO for UT Austin’s Dell Medical School, then went on a tear of them (consolidated here for easy reading):
Exhibit 2: When a Med device vendor tells you that you cannot encrypt their system because of “ FDA certification “ and therefore you complete a risk assessment stating that, literally attach a chain with a lock to the device, and put a camera on it with real time surveillance.
Exhibit 3: When you know that two hospital systems that won’t share data easily for competitive reasons is inhibiting a surgeon getting the priors on their patient, so you call your peer CIO and make an interface happen anyway and ask for forgiveness later.
Exhibit 4: When building code or infection prevention won’t allow you to put wireless access points in the elevators so the clinicians won’t lose connectivity with their mobile computers, so you go and buy a consumer power line network adapter and make it happen anyway.
Exhibit 5: When your hospital can’t keep track of Med devices & can’t afford RFID so you configure each device that broadcasts a MAC address to have an identifiable network marker so you can at least give the clinicians a “poor rtls” by telling them what AP it’s associated with.
Exhibit 6: When no matter how much you ask staff not to create duplicate MRNs for patients bc of issues with merging downstream, and they do it anyway bc of time / system issues, so you up front install a biometric patient reg system to quickly reduce your duplicate rate.
Exhibit 7: When folks constantly forget to encrypt their emails no matter how much you train them to do so so you configure DLP and your email system to catch any known permeations of ephi and pii in email and auto encrypt on their behalf because you know the consequences
Exhibit 8: When your social workers refer out a mental health patient to a specialty provider, a week passes and social worker calls for update on patient and if more follow up is needed? Referring site says “sorry HIPAA doesn’t allow us to share any info with you even with roi”
Then, Dirk Stanley, MD and Lucia Savage joined the action:
Meeting #1 : Nursing and quality say “We want to steer left, but you need to check with the doctors to make sure they are OK with going left.” Meeting #2 : Presentation to doctors who say they want to steer right.
— Dirk Stanley, MD MPH (@dirkstanley) May 15, 2019
When your doctor prints their visit notes, which you need for a life insurance application, and put them in a sealed envelope at the front desk instead of pasting them into a secure portal message.
Surely @HealthPrivacy has some too.
— Lucia Savage (@SavageLucia) May 15, 2019
Any health IT workarounds that annoy you. We’d love to hear them in the comments or on social media with @HealthcareScene.