Health IT Is the Means to the End – Not the End

In my role at HIMSS, I consistently ensure our message clearly states:  health IT is a tool in the transformation of health and healthcare. 

It is the means to an end – a health encounter in which clinicians and patients have the right information at the right time to make the right decisions – without breaking the bank.  Whenever I see language that puts health IT into the main role, I pull out the proverbial red pen and edit it. 

Over the past week, I’ve had the personal experience of how health IT, while a pivotal tool to improving the quality, safety, and cost-effectiveness of patient care, is not a silver bullet.  The health experience is a group exercise where the patient and clinicians, using sophisticated tools and effective communication, must work as partners to uncover.

On Tuesday, my husband went to his primary care clinician’s office to discuss a concerning symptom that had recently developed during exercise – pain radiating through his left arm and into his chest.  As it so happened, I was in Baltimore on business travel.  During my meeting, I received a text from my husband that he’s been transferred from his primary care clinician’s office to the emergency room.  Of course, I immediately change my plans and head home to be with my husband and daughter.

Through endless texts as I am making my way back home, I am kept abreast of my husband’s situation.  Our primary care practice and our hospital both use EHRs, and these EHRs are interoperable.  The hospital has electronically received my husband’s records, which he has checked and are accurate.  Thank goodness, the enzyme tests and chest x-rays performed upon his arrival in the ER were coming back normal; to be on the safe side, the staff decided to keep him overnight for observation and to perform a stress test the next morning. 

The next morning, the staff – using their EHR – shows us the results of two previous times when my husband has had a stress test.  They told us this information is very helpful, as he goes in for this latest test.  He does the stress test, and we wait for the results. 

After a brief wait, a clinical technician joins us and explains that – since my husband’s results were normal – she has the knowledge necessary to verbally provide us the information.  The staff has compared the results with the previous two tests, seen no change, so the tech assures my husband that everything’s fine; this is a case of non-specific pain. 

My husband asks the tech a couple of questions. She answers these with knowledge and aplomb.  And, the tech helps us understand that since we seem to have a number of questions, and before we ask a question she can’t answer, she’s going to see if the specialist has a minute to pop in. 

In all this time, no clinician has mentioned the left-arm pain during exercise that brought my husband into his primary care clinician’s office.

A few minutes later, a specialist appears.  He verbally hops right into restating the test results, reassuring my husband all is well.  Again, no mention of the symptoms. 

My husband and I politely listen to the specialist tell us what the tech had already told us.  He cordially concludes his remarks and turns to walk back out of the room.

My husband asks, “So, I shouldn’t worry about my left arm hurting and going numb when I run?” 

Literally, the specialist stops, turns sharply back to us, looks at my husband with laser-focused eyes and says, “You have what?” 

My husband repeats his question – which, of course, was the entire point of him seeing his primary care clinician in the first place. The specialist sits down, listens intently, asks a number of pointed questions, and arranges for my husband to have a coronary CT scan.  That test clearly showed a dangerous situation and my husband is now undergoing a heart catheterization.

As we all work collaboratively to transform health and healthcare, it’s imperative that we put health IT into perspective.  Without it, I firmly believe a positive transformation is beyond our reach. With the effective use of health IT, and with a partnership between patients and their caregivers, the sky’s the limit. 

What are your experiences on how health IT and a patient-caregiver partnership have worked together to result in great care?

About Carla M Smith, MA, CNM, FHIMSS

Carla M Smith, MA, CNM, FHIMSS , is HIMSS Executive Vice President.
This entry was posted in Blogging, Interoperability & Standards, Patient-Centered Systems and tagged , , . Bookmark the permalink.

4 Responses to Health IT Is the Means to the End – Not the End

  1. jasonhan129 says:

    Reblogged this on health it rant and commented:
    “The health experience is a group exercise where the patient and clinicians, using sophisticated tools and effective communication, must work as partners to uncover.” well put!

    • Carla M Smith, MA, CNM, FHIMSS says:

      Your comment is spot-on, Jason. Patients must be their own advocates. And, when they can’t, a family member or caregiver must help them.

  2. Most patients might have naively thought that the reason for going to the ER in the first place might be carried throughout the extensive records that were created… This is really an important concept, as too many patients might have figured that the issue with the arm was taken into account with all the tests, and the patient could have gone home, happily reassured and then could have been struck by disaster.

    The listening skills of both the patient and doctor are critical, but the imbalance of power in that relationship can mean the patient is intimidated into silence, or assumes all his questions have been answered.

  3. Carla M Smith, MA, CNM, FHIMSS says:

    Appreciate your remarks, Peggy. My husband & I have been struck by how easy it would have been for us to simply accept what the tech and cardiologist told us post-stress test. My husband didn’t have to ask the question he did. He could have just thought “oh – everything’s okay. That arm pain’s not a worry.” We have to be brave enough to ask and explore.

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