So #hic12 is nearly here and I’ll be there in a rather unusual capacity. I won’t be giving a talk. I won’t even be standing in front of a poster. I’ll be there as the official twitterer, which means I’ll be flitting around from talk to talk, tweeting from the official @hic_2012 account, and hopefully connecting people in the sort of decentralised organisational process we’ve all come to love about the medium. It’s on from the 30th of July to the 2nd of August and the details are, you know, on the website.
So what’s health informatics all about? Well, at its essence, it’s really about helping doctors, medical practitioners, and clinical researchers do better medicine. Sometimes it’s also about helping patients to help themselves. And pretty much always, it’s about information – spreading it, keeping it private, fitting it together, and using it to improve things.
For all the money thrown around in supporting new technology in healthcare delivery, we don’t seem to have made the sort of progress you might expect for such a critical part of the community – the bit that looks after you when you’re sick. So when you talk to people from outside medicine and healthcare about what actually happens in hospitals and practices around Australia, it’s not a surprise that they’re shocked.
“So the system is paperless, right?” Not even close.
“So the systems aren’t even connected to share information *within* the hospital?” Nope.
“So, I can’t register for an electronic record if my name has a hyphen or an apostrophe?” Haha! no.
It’s hard to believe that this is how things are in healthcare when in the rest of our day-to-day lives we can just download apps on devices to recognise a song/picture we hear/see on the street, connect to people around the world instantaneously, stream live videos of protests to thousands, run away from imaginary zombies to motivate us to stay fit and healthy, and ask Siri to tell us what gets prescribed to patients like us if we visit a doctor. But when it comes to changing technology in the sacred world of medicine there are a few things that get in the way – safety, bureaucracy, the cultural status quo, and profiteering.
And it’s those things that I always want to hear about at conferences on health informatics. Instead of asking what amazing things could be done with the new and ubiquitous technology we have surrounding us, we tend to ask and answer the following:
“How will you make sure that it’s safe?” It will take us many years to evaluate its safety but first we need ethics approval, which will also take way too long.
“How will you know for sure if it is effective and worth the cost?” We will have to test it in the real world, which is in a constant state of flux, so, ummm, actually, we won’t really be able to tell you how effective it is anyway – we’ll guess.
“And it will only cost you a billion dollars!” What?
“How will you convince clinicians to use it?” Oh, there will be resistance. People prefer to maintain the status quo because they work in tightly-constrained worlds with little room to move and adapt. So yeah, there will be resistance.
Meanwhile, there are some impressive people doing some rather amazing things to address the problems, break down the bureaucracy where it isn’t needed, and generally make the kinds of changes to the system that we can be proud of. Quite a few of them will even be at the Health Informatics Conference in Sydney at the end of July.
If you’re going to be there, I’d love to hear from you, find out what your Twitter account is, and add your talk or poster to my tweeting itinerary. If you don’t have a Twitter account and you work in health informatics, I’d like to know why. And most importantly I’d love to ask you how your work addresses or side-steps some of the above problems. I’m looking for disruptive technologies.
adam g. dunn 