Can Today's Doctors Be Competent Without Computers?

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Can Today's Doctors Be Competent Without Computers?

http://www.medicalnewstoday.com/articles/115431.php

Physicians who do not use the tools of information technology (IT)

such as electronic health records and computerized entry of

prescriptions could fall short of professional standards, according

to a new review.

Although technology cannot replace thoughtfulness and caring, it is

increasingly difficult to be a competent doctor without tech support,

contends Mechanic, Ph.D., of Rutgers University in the June

issue of The Milbank Quarterly.

However, it is important to view health information technology " as a

tool and not as a substitute for physicians' vigilance and

judgment,' " said Mechanic, who analyzed scientific literature, Web

sites and his own experience working with medical professionals.

The " increasing complexity and demands of patient care, along with an

explosion of medical knowledge, can make it increasingly challenging

for doctors to provide care that is fair, economical and aligned with

the best practices, " Mechanic said. Tools like evidence-based

treatment guidelines delivered to a doctor's computer " can help

physicians overcome some of these barriers barriers that must be

overcome if they are to be considered competent physicians delivering

the best care. "

" In addition to having more active patients, physicians now have many

more treatments, options and choices to consider and explain, " he

said.

E-mail communication with patients, automated reminders and

specialized Web sites and disease registries can help doctors do more

in the smaller amount of time allotted for patient care, the study

suggests. Automated reminders can also help patients stay on top of

their chronic diseases.

However, physicians in the United States have been slow to adopt

health information technology. Because of high implementation costs,

larger managed care programs and large group practices are more

likely to use these systems than smaller independent doctors'

offices, according to Mechanic.

However, Mechanic and others say cost is not the only factor that

could make smaller practices which make up the majority of physician

care in the United States reluctant to adopt new health information

technology systems.

" One thing that we're seeing is that in order for health IT to be

used effectively, the software has to be modifiable to fit physician

needs and work flow. Software also has to align with other IT

systems; for example, electronic medical record systems must work

well with existing or new systems for billing and e-prescribing, "

said on, Ph.D., a senior research scientist in health

care organization and systems at the Agency for Healthcare Research

and Quality. " At the moment, only the biggest systems have the

ability to build software that fits their own needs or fully adapt

available products. "

Larger health care organizations can tailor these systems to their

physicians' needs, disabling unnecessary alerts in a computerized

physician order entry system, for example.

Many clinicians in smaller practices " seem to expect software

products that come off the shelf to be immediately useful to them.

Instead, without appropriate customization to the physician's needs

and the workflow of the practice, the pre-constructed software may

actually interfere with the clinicians' work, " on said.

The Milbank Quarterly: Heidi Bresnahan, publications manager, at

(212) 355-8400.

Mechanic D. (2008) Rethinking medical professionalism: the role of

information technology and practice innovations. The Milbank

Quarterly 86(2), 327-5.

Health Behavior News Service

Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210

Washington, DC 20009

United States

http://www.hbns.org