In this new age of modern, enlightened EMR-hood, there is no way around it:
You will have to get cozy with your IT support staff.
Really cozy. On better terms with them than your spouse, cozy.
Unless you want to be spending at least as much time working with your hardware, software, and systems integration issues as you do with patient care — and even then, not fully taming the tech side.
I’ve been up to my armpits in EMR related work, advising an MSO that supports a local implementation in Southern California. New upgrades and conversions, retraining folks and developing teaching materials, testing the new features with the MSO programmers, filing down the rough edges to fit…
Finding new rough edges, and filing those down.
Pulling all nighters.
It’s a full time job, and I’m only consulting half time!
And I’m an interface and end-user testing guy; I’m not even writing or re-writing the actual software code.
Not In the Military, But…
Think about what you, as a provider of medical services, do daily:
You have a supply chain a mile long, relying on phone staff, back office assistants, pharmaceutical suppliers, and colleagues in other offices or hospitals.
Communication with your patient is critical — and often less clear than both of you would like.
And technology — whether electronic record, appointment reminders, or email, blog, and text messaging — can either help you or hurt you, as is true of any tool. But it can’t substitute for the basic human skills of attentiveness, empathy, and careful consideration through the lens of experience.
I don’t have a hidden wish to be in uniform, but I believe we really are the civilian version of the military’s “pointy tip of the spear.” When it comes to health care, what we do is about as mission critical as things get.
No argument so far, I trust.
Pobody’s Nerfect
There’s always been what’s been termed “the fog of war,” and likely always will be. No matter how many good people and good intentions and conscientious preparation you have on your side, there’s no such thing as a guaranteed, painless path to victory.
“Real boats rock,” as Frank Herbert said. No day starts off so gloriously that it can’t go to heck in a handbasket in an instant.
Poop happens.
This isn’t a theory; it’s a historical observation of the entropy of the universe. While it may not be as bad as my senior surgical resident said (”See that parking lot out there? Every one of those cars is full of people just waiting to bag you”), there are imperfections in any system. Chaos Theory, in fact, tells us that imperfections aren’t oversights or the consequences of poor parental upbringing, they are by definition going to be present in any sufficiently complex system.
Real boats don’t rock because the shipwright didn’t design the keel properly. They rock because that’s what the ocean does.
And of course, in the grand system of EMR, IT staff, office support, family, and colleagues, one of the biggest parts that can “rock,” will be us.
How many of us can even control our selves enough to traipse smoothly through life’s dandelion patches?
The best we can hope for is a setup that corrals our imperfections, that will encourage us to do our duties better, and that will do so forgivingly, instead of fighting against us.
So What Can YOU Do?
There are imperfections, and there are eye-crossing logistical nightmares in the making.
Having your IT support “distant” from your peculiar implementation falls under the latter category of SNAFU.
Out of the area tech support works, if you have an ultra standardized setup — the exact same hardware, software, and interfaces in your office that the tech support person in Bangalore has during your phone call.
But in today’s EMR world, that just ain’t so. Customizations unique to your office typically occur within weeks or months, and as I alluded to in a prior post, the network partners change locally within just a few miles of any implementation (different pharmacies, different hospitals, different laws, different interfaces).
Distance does not make the heart grow fonder, in the EMR support world.
In my opinion, you keep your friends close, your enemies closer, and your EMR IT support closest of all. Get them to marry into the family, if possible. You will need them much more often than the proverbial plummer, auto mechanic, and lawyer.
Next, reconsider slitting your own throat:
In my experience, the best clinicians and workers among us are often somewhat demanding and periodically rigid – you have to be, to get things done in a sea of entropy. You know people like this, may even be one of them: they tell it like it is, say bald, unvarnished things, and are generally a little unpleasant to go visit.
IT people love folks like that. Really, they do.
There’s a difference between the clinicians that don’t read the instructions and don’t care to, and the clinicians who have an honest beef with the system because it isn’t helping them win the war. Professionally, IT staff always admire and respect the latter.
Those clinicians are trying to close the distance between what wins battles here, and what doesn’t out of the box from the manufacturer over there. And closing the distance is what makes everyone smile, in IT support.
BUT, there’s too much of a good thing sometimes: piss and vinegar can make smiles tight, real quick. And if you could care less about irritating people while you loftily maintain your personal integrity, think back to the military analogy, or even your med school days:
- Do the lieutenants piss off their sergeants?
- Do the sergeants piss off their supply contacts?
- Do the med students piss off the floor nurses?
Kind of universally vital, those “support” folks.
Get thee hence from the prima dona mindset; your digital future rests squarely on the shoulders of a village of IT support staff, shucking and jiving at the speed of light. You will never voluntarily want to be far from them, and they wouldn’t have jobs without you.
Make nice.
