Plugging healthcare into information technology has been a long and tedious task. While corporate America has long embraced Internet-style computing, over 67 percent of physician offices still do not use electronic medical records (EMRs), but rather still rely on old-fashioned – and error and loss prone – paper documents. And although progress is being made, pushed by a $19 billion stimulus package from the Obama administration for health IT, privacy, infrastructure, and reimbursement issues continue to hinder the digitizing of medicine.
But there are revolutionary health IT leaders, among them, Children’s Hospital in Boston, where clinical processes, from e-prescribing to lab reports, are all done electronically. “From the moment you walk in the door, to when you check out of the hospital, is all tracked behind the scenes,” says Brad McDonald, lead application developer, just one of the hundreds of information specialists helping to change the way healthcare is performed in the hospital. “Computers can reduce errors, eliminate variance and redundancy, but having a computer in the workplace can be a major change and forces people to conform to a certain way of providing care.”
McDonald, who started his career at a supplier of healthcare IT solutions, says that being on the technical support staff for a pediatric hospital can be “high stakes stuff. These are systems that guide people down a certain path, eventually guiding clinicians on how to provide for sick kids, so you have to be careful and cognizant of every decision you make, because patients are involved.”
Q: Healthcare is 24/7. Does that mean as an IT person, you’re always on call?
A: The hospital is always open, so there’s always someone accountable in our department. We have a rotating pager among the staff. I’ve been called in the middle of the night or had to pull over during rush hour traffic to answer a page. It doesn’t matter if it’s 3 a.m. on a weeknight or Christmas Eve. Because it’s healthcare, we need to respond right away.
Q: What sort of issues are you dealing with?
A: It could be an error message; an application that’s crashing; a window that doesn’t launch; the system could be extremely slow; background processes can fail; or they may not know how to respond to a medication alert warning them of an allergy. In the latter case, it’s not my role to get involved in patient care but rather defer them to the appropriate expert, such as a pharmacist.
Q: You also deal with some ongoing projects, such as…?
A: We’re working on bar coding for medication administration, which is scanning bar codes on the drug as well as the patient wristband to make sure that the nurse has the right patient, the proper dose, at the right time.
Q: What skills are needed to do your job well?
A: You need to have a working knowledge of what goes on in a hospital, so that’s a bit of healthcare acumen. On the technical side, you should understand about navigating the UNIX operating system, and know SQL (Structured Query Language.) And you need to be someone who works well with people. There’s a perception out there that if you work in IT, you do a lot of introverted work, but that’s not the case at all. We don’t spend as much time as you might think in front of the computer, but rather working with clinicians as well.
Q: Do you get to interact with the children at Children’s?
A: We’re actually in a building down the street, on Yawkey Way, next to Fenway. But knowing that I’m helping sick kids get better gives me a sense of purpose. This is a job you can feel good about.