Health IT

Why healthcare isn’t ready for innovation: Docs, vendors, hospital hiring practices

Sean McCownI just left the healthcare industry for the second time and it’s sad the level of ignorance and superstition that exists around computers . . . and SQL especially. The entire industry treats computers like big electronic pieces of paper. They print things they can easily email, they manually enter in things they could easily write a form for, and they perform repetative manual tasks they could easily script. It’s pathetic how far behind the industry as a whole is and the people who work in it are so close-minded I don’t see how they ever get anything done.

Part of the problem is the doctors. Doctors think that because they’re doctors that they know everything. Several times I’ve had one doctor or another tell me specifically how they wanted me to do something in SQL. They didn’t know the first thing about it, but they heard a few terms here and there so they decided to run the show. And here they are in meetings insisting that I follow their HA architecture that was just ridiculous. I got a reputation in my company for being difficult to work with because I always called them on it and told them to let me do my job. Then they would complain and my boss would be at my desk the next day. It’s just incredible ego to think that you’re a expert in all fields because you’re an expert in your own.

However, doctors aren’t the only problem. Vendors are also a huge problem because they’re very slow to adapt to new technologies. And by slow, I mean 15-20 years too slow. We’ve had so many vendors who only code against SQL2K. Their support personnel is pathetic to say the least as well. These vendors know nothing. And they’re guiding hospitals in their implementations. And of course now you’ve got the blind leading the blind because while there’s nobody at the vendor who knows what he’s talking about, there certainly isn’t anyone at the hospitals to call them on it. And when they do get someone in there who knows what they’re talking about they can’t keep them because what really good IT person wants to work with an entire floor of people who don’t know the first thing about IT?

The biggest issue we had with staffing was that everyone who does the hiring thinks that you have to have hospital experience to be able to work in IT at a hospital. So they end up hiring ex-nurses, or other clinical people and give them jobs as programmers, system admins, etc. These people don’t know the first thing about being in IT or about C# yet they’re given positions based off of their hospital tenure. So someone who wanted a career change could come in as a Sr. Programmer yet they’ve never even had a simple online coding course. So now they’re in there trying to figure this stuff out. They’re architecting solutions that they could barely qualify as end users for. And anyone in IT who knows what they’re doing has to put up with this idiocy. And make no mistake . . . it is idiocy.


The industry itself has too many older managers in it, and they need to bring in some fresh blood that actually knows something about IT and how to actually get things done. As it stands they’re just too scared of the change, too scared of the data, too scared of being sued, too scared of pissing off the doctors, and too scared of technology in general. Oh sure, they’ll bring in iPads for the doctors to carry around, but big deal. They’re not doing anything cool with them, and everything they put out there costs tons of money in support because they weren’t put together correctly.

Want a perfect example of how far behind they are? Whenever you go to a new doctor you still have to fill out all that damn paperwork by hand don’t you? You have to put your name, address, SSN, DOB, etc on like 9 forms. Doesn’t that sound like something they should be able to get past by now? And there’s more to that specific story than just being afraid of computers. That particular one is caused by the system itself. I won’t go into specifics though. I’ve also seen plenty of people print online forms, fill them out, and then scan them back in and store that into the DB in a text column. Seriously?

So what can they do to change? How can healthcare move into the 80’s? For starters they can hire some younger, more hip managers who understand how IT works and the benefits it brings, and give them the power to do what they need to do.

Next they can stop hiring from hospitals. C# coders, or SQL guys don’t have to know crap about your business. They have to know their business, which is IT. And they’ll have to pony-up the money for some real IT folks. IT folks aren’t going to work for peanuts… not when they can go somewhere else and get 20-30K more. Oh yeah, and you’re also going to have to start treating them like they’re professionals. IT guys don’t want to hear how much the doctors know about IT. They want you to let them do their jobs. So seriously, stop treating them like they’re nothing compared to the doctors. Doctors are essential to hospitals, but your IT staff is too. It’s getting so that hospitals are crippled without IT. So why do you still insist that all IT guys are the same? Hell, even all janitors aren’t the same. I can easily tell the difference between one who cares about what he does and one who doesn’t.

Here’s a scoop for you. Healthcare is going to need to get their act together or else. The government is mandating that everyone have their health records in a meaningful use format by 2015 so the time of getting by on the idiots you’ve got is over. You’re going to have to get some real talent and do what it takes to keep them. If that means paying them a good salary, and listening to them, then all I can say is “you poor baby.” Hospitals jump through hoops all the time to attract some new doctor because of what he brings to the network. If anyone in healthcare is reading this then you’d better start planning now. Start gathering some talented IT guys and let them do their jobs.

And NO, before you ask, you don’t know what IT talent looks like. Get someone to help you find that talent. And I’m not talking about recruiters either. Go to the Microsoft MVP site and Google someone in the field you’re looking for and start emailing them. Ask them to help you interview a few guys. I’m sure they’ll charge you a little, but it’ll be more than worth it. Then once you get these guys on staff don’t treat them like 2nd-class citizens to the doctors. You’ve got no choice anymore. You have to do something. You can’t keep this up.

My guess is that it’ll probably take about another decade before this starts really turning around though.

This post originally appeared on DBARant.

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