I’ve gone on record as saying that engaging people in behavior change is about psychology, not technology. I still believe that. However, I’ve learned through my own experiences, reading about the health care IT industry, and talking to stakeholders in various hospitals, health systems, and health plans, that sometimes the roadblock to engaging people isn’t the psychology at all.
Sometimes it is about the technology.
Specifically, many providers are operating with older, non-integrated IT systems that make it very difficult to share information and coordinate patient care. As of 2012, providers are encouraged to use electronic medical records as part of the Affordable Care Act; yet, with many different systems on the market and a frequent lack of budget and support within provider systems, the implementation of this technology is often far from ideal. Technology gets in the way of effective coordination of care and timely delivery of necessary information, instead of facilitating it. As a recent study by Chilmark on patient engagement showed, physicians may focus more on the technology tools themselves than on technology as a facilitator of the patient relationship.
Lack of integration and cooperation between pieces of technology matter at the individual level, too. Consider my coworker Reva, whose doctor can’t check the data from all of her devices to help manage her Type 1 diabetes because she doesn’t have the right sets of connections in her office. As Reva puts it, “I feel like my diabetes is a puzzle and my doctor is only looking at a handful of pieces when telling me what to change.”
My team spent a day a few months ago with a top provider team from a world-renowned medical institution. The providers worked for the same department in the same system, but operated out of two different physical offices. The two offices do not use the same electronic medical record software. This means that despite being colleagues and despite sharing some patients, the staff has no easy way to electronically share information amongst themselves. Imagine the obstacles this puts in the way of optimal patient care. And it’s all the more frustrating because of the high level of motivation, skill, and compassion these particular providers bring to the relationship with their patients.
In an ideal world, technology operates seamlessly behind the scenes while care providers and patients collaborate. In the real world, work is needed to integrate, streamline, and connect the technology tools that have become part of our work processes.