Re: Walmart Health: Just had a great dental visit this morning, which was preceded by helpful reminders from Epic, and…
HIT Leads to HID
What’s that you say? What’s HID? Oh, sorry. That’s a new acronym going around related to the semi-rapidly-changing world of HIT.
HID stands for Health Information Disappointment.
If you’re anything like me, that definition rings both a cord of immediate understanding as well as a bell of bittersweet irony. If you’re a user of HIT to document, derive, or disperse health information, it is almost a guarantee that you intimately know the aches, pains, and disappointment involved.
Despite any (all?) HIT vendor’s best promise to the contrary, documenting digitally can be exasperating. The difficulty of completing virtually any digital documentation of a healthcare task is often harder than performing the task itself. (OK, so maybe certain procedures like quadruple coronary bypasses or triple organ transplants are harder than the documentation thereof, but the comment stands for many of medicine’s more commonplace care tasks.) Some systems do the documentation dance with more fluidity than others, to be sure. However, for many (most?) providers out there, recording their necessary daily data to adequately comply with all requirements – be they reimbursement or incentive – has become decidedly dreary, dull, and a drain upon their day.
(While writing this piece, Dr. Andy Spooner posted a very insightful “rant” entitled Scout’s Honor that highlights one very significant facet of this documentation dilemma. A good read.)
As disappointing as the recording of computerized health information can be, it isn’t nearly as disheartening as trying to derive information from another’s digital documentation – especially if it comes from a system outside your own, and even more so if it’s a printout version thereof. (So few systems actually share digitized data into reciprocally relevant information buckets that the conversation at this point is pretty much limited to printout information sharing, be it faxed or snail mailed.)
Digitized data entry has certainly eliminated the human eye-brain handwriting recognition and interpretation problem from the mix. However, it seems to have replaced that form of crypticism with one that, while legible, is often barely readable. Too long. Too short. Too poorly designed from a readability perspective. Too filled with reimbursement- or incentive-related gibberish that adds nothing of any identifiable value to the clinical narrative. If you’re a provider, you’ve seen each of these and you know how difficult it can be to divine the necessary clinical pearls of relevance from the splattershot of documentation detritus.
As to the distribution of healthcare information, well, that’s pretty much the reason fax machines are still being manufactured. We haven’t made too many advances for health data dispersal since the first commercialized version of the fax machine hit the markets in the mid-60s. (Sort of sad, when you think about it.) Sure, we’re starting to build connectivity and signs of sharing are certainly sprouting up here and there. Yet, the reality for most of us, most of the time, is that we’re still quite some distance from a system that shares data more effectively than our faithful old fax machines.
With healthcare’s current state of digitized over- or under-documentation, with medical storytelling that while legible is still cryptic, and with the ongoing limitations of health information sharing, is it any wonder that we have Health Information Disappointment?
From the trenches…
“I’m disappointed, but I’m not going to run around like Dennis Rodman and head-butt somebody.” – Greg Norman
(“Well … not yet.” – Dr. Gregg)
Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).