Psychology of Informatics Integration in Healthcare

Some Thoughts on the Psychology of Integration of Informatics in Healthcare; and a Suggestion Sanjoy Sanyal Former MSc student, Health Informatics, RCSEd / University of Bath, UK Presented @ Middle East Conference in Health Care Informatics Dubai on 10 th April 2005

Financial Constraints in Healthcare
Available resources are always several paces behind the demands on healthcare.
Whenever national budgets need to be revamped, healthcare sector is among the first to receive the axe.
When budgetary allocations are considered, healthcare sector is among the last in the dole list.

General Constraints in Healthcare
Healthcare facilities are often understaffed and under-equipped ; providers are generally over-worked.
Wide inter-regional and international variation in scope and depth of healthcare infrastructure
Healthcare sector lags behind non-healthcare sectors in IT implementation

Psychological implications - 1
Feeling of being left behind by the world
This has served to make many of us go on the defensive, even bordering on the diffidence.

As a belated knee-jerk attempt to catch up with the Joneses…
We are engaged in a race to anyhow implement informatics in healthcare, often without proper background study.

Smarting from this state of affairs…
We are unconsciously trying to mimic other disciplines in our attempts to integrate informatics in healthcare.

Mixed Psychological Interplay Hesitation Overambitious Diffidence Inferiority complex Grandiosity Defensive attitude Mimicking Copycat syndrome Not recognising faults

Re-orienting our psychological personae - 1
We should not flog a tired / dead horse: When a system is in its death throes …
Should have the wisdom to recognize it
Should not throw good money after bad
Have the humility to admit our faults, learn from our mistakes, cut our losses, and plan again more rationally for the future…
With a balanced perspective

We should avoid being a “ me too ” chick: Implementation of a system should not be just to say, “ We also have a system in place .”
Is this what we want or need (?)
Is it benefiting our patients (?)
Is it supporting providers in their work (?).

We should not swallow more than we can digest, like boa constrictor:
Informatics plans should not be overambitious and grandiosely expensive
Should be just right for the POC
Requires possessing the right perspective of the magnitude of the problem.

We should not be a copy-cat: Trying to blindly mimic other healthcare / non-healthcare implementations.
Each place has its own unique set of requirements and resources; system implementation should match these two

We should not get into a rat-race:
Non-healthcare domains are way ahead, or
Other healthcare facilities have expensively computerized their activities
These should not be deciding factors in our decision to do the same with our POC.

Communication and Patient Anamnesis
Diversity of information
Ambiguity / confusion of classifications and terminologies
Problems of data entry
Problems of interpretation of coded data
Importance of, and problems in, anamnesis capture

Anamnesis Capture
Computerised voice dictation system:
Logical progression from Dictaphone , but…
NLP is still in infancy
Mainly operational in X-ray reporting environments with a keyword macro-type language.

Anamnesis Capture – Potential Solution
Record and store spoken word directly into the EPR
Capability is available now; may overtake quest for converting spoken word to text
Lateral thinking is needed.
Patient communication (a la humanities / social sciences) can be included in DV format (reduction in cost of multimedia, increasing versatility)

Instead of trying to ‘code’ patient narrative, capture anamnesis in audio/audiovisual files
Break into smaller manageable sections, with hyperlinked subheadings, and store
Click/point on relevant linked subheading to see / hear patient anamnesis recording

4GL multimedia compiler (for audiovisual anamnesis ), which would be compatible with most of the common OS in PCs

Multimedia Compiler – Features
Audiovisual anamnesis, database systems, patient data banks, knowledge transfer / complex tables, PC technology for video/screen titling, synchronization
Multimedia translation PCs / "speaking" question catalogs in different languages (digit interpreter)
Representation of logistic operational sequence, process animation and visualization

Multimedia Compiler – Network and Control Systems
Information and control systems for hospitals
Multimedia information networks
Network communication in hospitals, multimedia patient information
Radio data base access on central server
Global data base accesses by Internet (‘intelligent’ / associative term search
Internet video-phones / full-duplex video conferencing

Conclusion – 1
Healthcare informatics implementation : Complex entity without any comparisons with other domains
Socio-cultural
Psychological
Technical
Commercial
Political

Conclusion – 2
Patient anamnesis audio/audiovisual capture
The theoretical perspective should form a test bed for practical validation through collaborative research .

Psychology of Informatics Integration in Healthcare

by Sanjoy Sanyal

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Psychology of Informatics Integration in Healthcare Presentation Transcript