I work in healthcare IT (Information Technology) as an Interface Analyst. It is my job to make disparate healthcare computer systems talk to one another using an interface engine. Think of an interface engine as a translator. It sits in between two different computer systems, and it does translations. Some simple, and some complex with many types of decisions and logic built in. It takes the data in, translates it, and routes it to the other systems that need it, all in a few seconds.
It’s quite fascinating”¦ as well as a bit scary. Most of us take the technology piece of our healthcare experience for granted. We don’t pay a whole lot of attention to it and we certainly don’t question it. We are just happy when we don’t have to give our name, date of birth, and insurance information more than once.
The thing is, our information is being sent electronically to many different places, both inside and outside the healthcare organization. Our doctors don’t want faxes of reports any more. They want reports to automatically file into their own computer system. Paper medical records are going the way of 8-track tapes and floppy drives.
Let’s consider the following scenario:
You get in a car accident and have to go to the emergency room. Your information is entered into one system, and then flows to the Emergency Room Application where your vitals signs are entered, your hurts are documented, and your medical history is reviewed.
Your leg hurts, so they order a leg x-ray, they also draw blood for lab work just to make sure there isn’t anything else going on. While your blood is on its way up to the laboratory, the order and your information have already been accepted into the laboratory system and the order for the x-ray is in the radiology system long before you arrive in the x-ray department.
The blood work is done. The images are taken; the doctor reads them and dictates the findings of your exam. The x-ray report and lab results are available to be viewed in the emergency system not long after you return. The reports also get sent to your primary care physician and to the state’s Health Information Exchange ““ electronically.
During your visit to the ER, your data is zinging around the hospital faster than an ambulance can drive. I make all of that happen with the help of technology. I write the code that makes all of that possible.
Just imagine how much time and human effort is saved, by not having to hand deliver orders to other departments, to not have to pick up the phone to call in the results of the lab work. There is no need for a data entry person because there is no duplicate data entry being done (name, date of birth, gender, etc.); it just flows to whatever system needs it.
It is a wonderful thing– when it is working properly. It saves on manpower, money, and time. But when it doesn’t work right, when things go wrong, bad things can happen. It is, after all, patient data, much of it critical to the patient’s well-being.
If we aren’t diligent, things go awry. One little mistake could potentially HURT someone. It isn’t something I like to think about, although it is always lingering in the back of my mind. Patient care and safety is my biggest concern.
As patients, we tend to not think about it until something bad happens and then it is too late. Always remember, that a computer system is only as reliable as those that worked on it. (The programmers, QA, implementation staff, analysts, and ultimately the end users.)
I rely heavily on my co-workers to help me come up with the requirements for my code. I rely on them to help come up with the scenarios for testing purposes. I rely on their expertise in their respective areas, because I may know how the data flows and why, but I am not a subject matter expert for the actual data.
I find it mighty scary that with all this healthcare reform, that we have to create more of these interfaces, we have to pass patient data to more and more systems and organizations. One such organization is the Health Information Exchange ““ which is a statewide repository for health records of all patients in the state. Your data will go there regardless of if you want it to or not. Your only “opt out” option is log into this Information Exchange and make your records invisible to providers/doctors/care givers. BUT it will still be there; it will still get sent there.
You. Have. No. Choice.
I worry about the data being sent, about its accuracy. Do you trust other human beings to do a good job coding/testing the systems and interfaces; do you trust them to monitor everything so that everything is working as it should be? What happens when a mistake is made? What if a doctor makes a decision based on an inaccurate report? What if”¦
I know if I could, I would find myself a doctor that did not use computers in their practice and one that instead utilizes paper medical records. I know I would opt out of any and all interfacing of data outside the hospital walls. I know I would nix having a doctor or care-giver send my prescriptions to the pharmacy electronically.
Technology is a wonderful thing, when it is used properly, when it is implemented with care. When those involved are conscientious and diligent. Yes, technology pays my bills, but there are too many points of failure”¦ I am not ready to trust it. But like I said, it isn’t like we have a choice.