Tech Shock and the Virtues of Incrementalism
Fam Pract Manag. 2001 May;8(5):12.
You have heard it from any number of sources now, including the Institute of Medicine: Information technology is vital to the future of health care.1 And chances are very good that, some day in the bright, not-too-distant future, you will be part of a computer network/Internet arrangement connecting everyone from your patients to your labs to the health plans you contract with. It will all be integrated, wireless, convenient and idiot-proof.
The catch, of course, is that you probably won't be using any of the “information technology” you are currently familiar with – not the computers that now grace your office, not your practice management system, none of the computer programs you're used to and probably not even the same kinds of hardware. Mind you, I don't have a clue what technology you will be using. I just know you and your staff will be swimming in it. The evidence that properly implemented technology prevents medical errors, increases efficiency and improves care is just too strong. Moreover, the power and ease of use of computers are growing too fast, and the price per unit of computing power is decreasing too fast.
Think about a practice where patients make their own appointments online, where the computer reminds you of preventive care needed by your patients (or reminds your patients directly), where patients request refills online and refills are transmitted electronically to the pharmacy, where you can have your computer system follow up with patients to make sure they're taking their medicine and not encountering side effects and where you can get evidence-based answers to your clinical questions in seconds. If the gulf between your current practice and that practice seems to involve more than a little culture shock, it's none too soon to start preparing yourself. How? By at least dabbling in today's technology.
Learn now; avoid the rush
Learning today's information technology is a little like studying Latin to prepare for a move to France; it helps, but you'd do better to study French. The problem is that there are no Berlitz courses in tomorrow's technology, because nobody knows the language yet. And learning Latin is, after all, helpful to someone who wants to learn French. When I first traded my editing pencil for a computer, the computer I used was an early IBM PC. It had no mouse, no color screen, no modem, no e-mail, no Windows, no hard disk drive, no graphics capability, no computer network connection, no CD-ROM drive and no more than a thimbleful of memory. And yet I would guess that 90 percent of what I learned then makes my life easier now. Find places for today's technology in your practice, and you'll be much more ready for tomorrow's.
How can you dabble profitably? Easy. Try one or more of the following:
Search the World Wide Web for answers to clinical questions – or any other questions, for that matter.
Get yourself an inexpensive hand-held computer and use it.
Download the qRx and qID databases from www.epocrates.com to your hand-held (at no charge!) and free yourself from the PDR.
Use your hand-held as a tickler file to ensure that patients return for follow-up visits (see page 50).
Experiment with an inexpensive electronic medical records (EMR) system. Better yet, make yourself a rudimentary EMR for free (see page 33).
Use e-mail, and join at least one e-mail discussion list for family physicians. See www.uib.no/isf/guide/family.htm for some examples. AAFP members have several more available to them through the members page of the AAFP Web site (www.aafp.org/members.shtml).
It really doesn't matter much what you do to learn, as long as you do something. If you like it, you'll have fun. If you don't like it, at least you'll be desensitizing your system. Who knows? Maybe you'll prevent technological anaphylaxis later on.
Robert Edsall is editor-in-chief of Family Practice Management.
1. Crossing the quality chasm: a new health system for the 21st century. Committee on Quality Health Care in America, Institute of Medicine. Washington, DC: National Academy Press, 2001.
Copyright © 2001 by the American Academy of Family Physicians.
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