Health IT

Why healthcare and technology are still not speaking the same language

Imagine two people carrying on a very pleasant and cordial conversation. As you pass by you note that they’re nodding heads in agreement and smiling. You then listen a bit more and realize that they are each speaking different languages and, in all probability, don’t really know what each is saying.

I’ve been to a number of meetings lately where technology and health professionals have been trying to explore how the amazing promise that breakthroughs in technology are making can be used to advance health and healthcare. Intuitively, it seems that the two would go perfect together. Trends in moving services away from traditional clinical settings, the need to be more patient centric and the advances in technologies related to mHealth provide fertile ground for this collaboration. However, I’m beginning to worry that there are some profound disconnects that threaten what should be a remarkable partnership. There’s a lot of nodding but I’m not sure that there’s that much understanding. There are clearly substantative differences in research methods but there seem to be disconnects in what are viewed as solutions.

The first disconnect is based on different understandings. Technologists hear problems based upon the technology they know. There’s much to be said about the phrase: “To someone with a hammer, every problem is a nail.” But it’s more than that. Even when we start with a common understand a problem solutions tend to drift toward functions implicit in the technology. This can cause a drift toward solving a different problem than the one in question or refining an attribute that is less relevant to the original problem.

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The second problem is that there is an inherent beauty in pure technology. It is easy to become focused on making a technology as “perfect” as it can be. Often in health, the existing standards of care can be quite low so “good enough” can be transformative. Working toward an elusive ideal may make sense from a theoretical framework but it may only delay interventions that are needed now.

Third, there is a mistaken assumption of symmetry in the relationship between technologists and health professional. The problem space comes from health and healthcare and is based upon a very practical framework. The health professional knows these and this reality must guide the collaboration. The solution space is likely to be technical but it must fit the reality. The technologist needs to communicate the solution in such a way as it is truly actionable. She also needs to listen carefully to the language that is actually being spoken. It’s difficult to bend reality to fit a theory not well based on the facts on the ground.

On top of this, one needs to align the very practical real world to this system. Collaboration between technology and health is complex and takes time and there are far easier realms to apply technology. But the potential payoff in making the world healthier should transcend the complexity.

Of course, all of this is based upon a belief that there is value in the solution and value is a very complex combination of evidence, design and execution.

[Photo courtesy of Flickr user ilamont]

Albert Shar, Ph.D

Albert O. Shar, Ph.D., is managing principal at QERT and finds practical technical solutions to today’s real world problems. Previously, Shar was the first vice president of information technology at the Robert Wood Johnson Foundation and served as a senior program officer for the Pioneer Group, seeking innovative projects that catalyze fundamental breakthroughs in health and health care. Before that, Shar was director for Information Technology Research and Architecture at the R.W. Johnson Pharmaceutical Institute, a Johnson & Johnson company, where he developed innovative ways to use IT to improve the drug discovery and development process. Prior to that, Shar held the positions of director of technology services, University of Pennsylvania Health System, and executive director and CIO, University of Pennsylvania School of Medicine. He has held research and teaching professorships at the University of Pennsylvania, University of New Hampshire, Swiss Federal Polytechnic Institute and University of Colorado. Shar is the author of more than 50 scholarly publications in medical technology, computer science, and pure and applied mathematics and holds a patent in medical imaging. More posts by Author

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