Wednesday, May 18, 2016

“All Encompassing Software.” Good luck with that.

There was an article in the Boston Globe yesterday on a new “all encompassing” system that Partners Healthcare (which includes pretty much all the top hospitals in Boston under its umbrella) has been rolling out. For $1.2B, it ought to be all encompassing, but some of the feedback coming from doctors and nurses using it is that it’s too hard to use and takes away from meaningful patient contact. Some medical professionals even said that having to learn it was hastening their retirements. For many, it’s not what the doctor ordered. Anything but.

I’m glad that Partners is implementing something that will eventually streamline the way that healthcare information is gathered and shared. They’ve been improving over the years, but they haven’t quite gotten to where they need to be.

Years ago, I had to wait for an appointment with a surgeon while he rummaged around in file folders, sitting in wheeled bins in the corridor outside his office, to find a copy of my mammogram. (Talk about HIPAA compliance.) When he finally dredged them up, I told him that all the information – including those scans – could have been available to him online. He was amazed that this was possible. This was maybe 20 years ago. Today, those mammograms are online. Yea!)

For years, when I went for my annual mammogram, I had to fill out exactly the same information (on paper). Gradually they went to a computerized input system, but for some reason, you still had to fill in the same info each year. Now it’s all better: you only have to say what’s changed since your last visit.

Still, I know from my husband’s relatively recent illness that there was a lot of information overlap and underlap. How many times did we have to give yet another doctor’s office a list of Jim’s medications? Shouldn’t that have been online somewhere?

And there were some doctors who for some reason couldn’t manage to get your appointments online. As of a couple of months ago, this was still the case for one doctor I see.

But, as I’ve said, from the patient-as-consumer point of view, I have seen improvements over the decades that have flown by while I received my healthcare through physicians affiliated with MGH, which is part of Partners.

My PCP (40ish) is great online: making appointments, answering questions, posting results, filling prescriptions. Her office is very easy to deal with. I’m happy to hear that I can expect even further improvements from the overall system.

Yet I am sympathetic to those doctors and nurses who are finding it rough going to make sure that everything they say and do now has to be digitized. It can’t be easy, and I do know what it’s like to have to work with a software system that is so all encompassing that it’s really difficult to use.

When I worked at Genuity, they introduced a major all-things-to-all-people “enterprise” system.

Profligate as Genuity was – and it may be time for another profligacy post: stay tuned – the company did not spend anywhere near $1.2B for our sorry-arsed system. But I do believe it was the most costly system of its time, between the software, the customization, and the consultancy that worked with us.

The system was rolled out with much hoopla. Everyone had to be trained up on it. We were all encouraged – and in some instances forced – to use it.

I was most interested in the customer relationship management (CRM) aspects of it, but it turned out to be worthless, as no one was putting in any data that was of interest. You could only find out the most meager info on our clients. Nothing that you pretty much didn’t know already. Big, honking, useless.

We also had to use the system to process our expense reports. I’m thinking this was the way in which they would at least compel those of us who traveled to utilize the system. It was so unintuitive to use that, even though I had carefully written out step-by-step directions, each time I had to submit an expense report, I had to resort to calling the help desk.

After the system was in play for a few months, some consultants did some consulting-by-walking-around and popped into random offices to get some feedback. One of them darkened my door and asked me about how I was enjoying our new “solution.” I had to tell her that the only way I would use the system regularly was if the president of the company was standing next to me, with a gun pointed at my head, and I knew that a) the gun was loaded, b) he was willing to pull the trigger.

So I feel the pain of the doctors and nurses struggling with their new system.

But here’s the thing.

I didn’t matter whether anyone used Genuity’s enterprise system or not. (Especially given that the company disappeared off the face of the earth.) But it does matter that our healthcare providers get things right. Keep trying, boys and girls. It’ll get better. It has to.

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