Tuesday, May 22, 2012

IT Priorities 
As an inveterate critic of how hospitals have gone about applying information technology, I enjoyed during the latter of my working years pointing out that while we were spending untold numbers of dollars and man hours trying to create an electronic medical record, we had not proved ourselves able to computerize our internal telephone directory.   And so at considerable expense we would issue an updated print version of the phone book every year or so. 
So it was with both amusement and interest that I noted a small story in the May 11 issue of the New York Times reporting that the government of the City of New York was for the first time publishing its official directory in digital form, available on the Internet at www.nyc.gov/greenbook.   
What this reveals, I believe, is that the internal structure of hospitals and governments is to a large extent political in nature, with decisions and priorities being affected more by the relative clout of the proponents than by the content of the matter under consideration.  In the case of hospitals, the people interested in medical records are more powerful than the people interested in telephone books and so when it comes to allocating information technology resources, medical records has a big leg up.   A modest investment in computerizing the phone book could save some money right away, whereas it is by no means clear that the enormous investment in developing the electronic medical record has ever yet produced a financial return.  But the priority goes to where the power is. 
I’ll still keep looking for the hospital that follows the example of the City of New York, but I’m not holding my breath.

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