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To get more from technology, bridge the IT-clinical divide

It's no secret that IT staff often speaks a different language from clinicians. But bridging this IT-clinical communications divide could be a key element of maximizing the impact of IT initiatives and improving the quality of care.

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Melissa Barthold, senior clinical solutions strategist at the University of Mississippi Medical Center, said that clinicians typically don't understand how data is collected or stored. This limits their vision for how technology can be used to improve care, and diminishes the benefits doctors and nurses derive from automated reports, among other things.

For example, Barthold talked about how one clinician at her facility asked IT staff to generate reports that included nursing mothers' health records of. The reports ended up including the records of men and older women as well. She said this incident illustrates both the inability of clinicians to describe to IT staff what they need and the lack of clinical understanding on the part of technical workers.

"We need to start putting data in in a way we can get it out," she said. IT and clinical workers both have a role to play. Doctors and nurses may improve the quality of their documentation with a better understanding of the technical processes that underlie what they're doing, but IT staff need to find ways to make data entry easier.

Part of the reason this divide persists could be attributed to the different ways clinical and IT staff approach their work. In her session at the HealthTech Council meeting in Chicago, Alisa Ray , executive director and CEO of the Certification Commission for Health Information Technology, said technical people generally approach projects in standardized ways. They sometimes even get criticized for being too rigid. On the other hand, clinical staff are more likely to take an individualized view of what needs to be done for each patient. This difference creates tension.

The standardized approach, however, is necessary for the success of IT projects, Ray said. While it might not be possible for technical staff to change that approach, they can adjust the way they present their work to doctors and nurses. Rather than telling clinicians they must document their actions in a certain way or deliver care according to a rigid playbook, technicians need to humanize IT projects and help clinicians understand how they will help patients. Solutions will have to come sooner rather than later. Ray said the penalties for unnecessary hospital readmission that recently kicked in as part of the Affordable Care Act will place a premium on information exchange. Hospitals need to have the technical ability to exchange patient data with primary care doctors, and clinicians need to use this information in a meaningful way. This means systems will have to be implemented and used in an interoperable manner.

"That's where the rubber meets the road, where the challenge is. There's a lot that happens in that implementation," Ray said.

Patrick Sullivan, director of the Captain James A. Lovell Federal Health Care Center, said he feels physicians are ready to embrace technology to care for patients. It's just a matter of making sure they understand the tools they have available and giving them tools that actually influence quality of care. "In many cases it's about ensuring that everybody understands what's being measured and what the impact is on the patient," he said.

Sullivan said providing clinicians with real-time measures of quality is one way to motivate doctors and nurses to embrace technology. It taps into their natural desire to deliver the best care possible, and can illustrate improvements that might follow the adoption of a decision support system or other piece of technology.

The growing number of nurse informaticists also could help bridge the IT-clinical divide, Barthold said. These professionals often are clinically trained nurses who have received extra technical training, so they understand both realms. As more nurse informaticists gain these kinds of skills, they could take on a larger role in hospitals serving as a liaison between clinical and IT departments.

Let us know what you think about the story; email Ed Burns, news writer, or contact @EdBurnsTT on Twitter.

This was first published in April 2013

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