Working in healthcare IT (HIT) means learning to quickly
adapt and implement new technologies at breakneck speeds. Healthcare has so embraced technology that
businesses must continue developing new and better methods of providing patient
care or else lose the competitive edge that is essential to their
survival. That competitive edge ensures the
best physicians are retained, patients get higher quality care which is safer
and less invasive, and the bottom line is maintained against ever decreasinginsurance reimbursements.
So where does the HIT professional fit in all of this? He fits right smack in the middle, holding
hundreds of spider-like threads together which stretch from the data center
back to every aspect of healthcare operations.
Technology is entrenched enough that a down server could mean a doctor performing
a heart procedure cant pull up needed images, or it could mean a recently
vacated patient room goes uncleaned because the bed and patient tracking system
couldnt send the notification page to the environmental services
employee. Heck, I just completed a new hospital
dietary system installation to replace an old paper system. So now every time the Citrix server crashes
(ahem, last night), I get a call from panicked dietary workers who dont know
what the patient in room 2217 ordered for dinner. Two months ago, they used an entirely paper
driven system, and now they are completely immobilized if their new electronicsystem hiccups.
To make matters worse, many times vendors ship out buggy
software in an attempt to be first with a new idea. I know, buggy software is not unlike software
being sold in every other market, but its impact in this case is to patient
care, which takes it to an altogether different level. Installing a poorly written software package compounds
the problems facing HIT departments because subsequent patches and
enhancements become less optional and more often translate into required
upgrades. Features seen on a glossy
brochure and included in a slick sales presentation are nowhere to be seen after
the initial installation or they often work less than perfectly. Lets see a show of hands if youve ever
installed a dot release upgrade to a system which wasnt yet live. My last system installation included four separate
dot upgrades before it ever made it to production status. Depending on the complexity of the system,
this could mean required updates and testing to database, application,
interface and terminal servers; not to mention updating workstations and
handheld devices or rebuilding automated software deployment packages.
In all fairness, often software vendors and HIT departments
are pitted against each other to solve implementation problems when the root
issue originates with a hospital director or president who purchases a system
without involving the people responsible for its installation. We bought this, now make it work is a
phrase Ive heard before. Seemingly out
of nowhere, a contract is signed, money changes hands and then its sent to IT for review and installation. Problems inevitably arise when youre
speaking with the vendors technical support, and they reluctantly inform you
that theyve never assisted with a thin-client implementation of their product or
dont know if their software will run on a virtual server.
However, vendors will work with you much of the time to
install their software according to the standards and technologies in your
environment even when their support documentation doesnt officially list it as
an accepted platform. But what happens
when they wont? Then IT is left holding
CDs for a purchased system which doesnt adhere to internal processes. A decision must be made at this point either to
refuse installation (this never happens) or engage in a bit of creative
engineering which involves magic behind a pulled curtain. Voila!
A new system is installed and no one quite knows how its working. Just dont breathe too hard on the server onthe left.
As computerized methods replace the last remaining manual
procedures in healthcare operations, IT departments find themselves playing a
direct role in the delivery of patient care.
This means promptly responding to problems that arise while juggling the
constantly evolving solutions passed down from vendors and into our laps. Now if only I could learn to recognize thebeta software builds from the final releases