IT - It's Not About The Bits Anymore

Two things happened recently that made me feel a little closer to the ambulatory care world. First, my sister got a job at a clinic as a business analyst. I'm very proud of her and am excited that she's joining the healthcare IT world! She's going to be great at it.

Second, I was recently at a clinic, wearing my operational excellence hat, doing some value stream mapping. They are going to be implementing an EMR soon and are looking closely at their current state processes to see where they might be able to streamline them. The hope is that doing so will help free up the time and energy that it'll undoubtedly take to get it up and running. I was reminded of a physician's email to a another clinic's project team. The best quote was "if you're not used to working with computers and technology get ready for the pain train!".

The culture and human change represent the real work. The process design and management piece is engaging and challenging. The technology can be equally complex but the truly hard part is helping people unwire the parts of them that rely on the muscle memory of paper, pen and pencil. To rewire those pieces with the habits and skills that make their transition to keyboard, stylus and tablet possible and as painless as possible.

For that and other reasons Gartner and other pundits forsee IT being less about the nuts and bolts. Less about buses, bits, boards and 4th generation languages and more about the relationships, conversations and art of change. I used to long for the good old days when I was a shepherd for a bunch of Digital UNIX, HPUX and Linux boxes. When it was just me, the hardware and a command line. Now that part of my brain has found more joy at home designing chicken coups, garden walls and the occasional bookshelf.

Instead I find myself doing value stream maps, investigating ROIs, understanding changes in CMS core measures and gathering high level requirements. It took me 13 years to get here. My sister was able to step into her first HIT job without ever seeing a UNIX command line or configuring a IP network. She's never hacked a registry or plugged an ethernet cable into a frigid datacenter patch panel. Instead what she has is far more valuable. Ten years of everyday experience working with doctors and nurses while they care for and treat patients. Ten years of immersion in the process of caring for patients. I hope I can keep up!