Thursday, August 31, 2006

Simple Things Can Be Hard to Learn

Providers of health care are under a lot of pressure to use computers to improve quality and reduce cost.

One popular application has been computerized physician order entry (CPOE). The idea is to have physicians enter their orders into computers rather than writing them out longhand. When an order is entered, information is displayed that potentially leads to better decisions by the physician.

Well, it doesn’t necessarily work. The Colorado Permanente Group in Denver reports that CPOE in that organization “did not improve physician compliance with laboratory monitoring alert recommendations.”

Commenting on that report, Susan Horn (The limits of technology, Modern Healthcare, August 7, 2006) described a project in which a group of nursing homes set out to reduce the incidence of pressure sores, enlisted the aid of information technology, and achieved a reduction of one third in a year’s time.

The difference between the two cases seems pretty obvious. The nursing homes had an improvement they wanted to make and used information technology to achieve it. The Permanente Group bought and implemented technology in the hope that it would produce improvement. The nursing homes succeeded. The Permanente Group failed.

Ms. Horn went on to point out that “…no technology…will cure our healthcare system of its ailments” and that technology is “….no panacea, but rather a tool for solving problems.”

In other words, the right approach is to figure out what problem you want to solve, develop a plan for solving it, and then use technology to support the plan.

Seems simple enough.

But the simple things in life sometimes seem the hardest to learn.

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