Thursday, June 29, 2006

Technology and Its (Dis)Contents

The issues around technology in our office are becoming more clear as the weeks since my last related post go by, although we all understand (don't we?) that technology that's supposed to make our work "easier" is not always so, or at least not in the beginning, anyway. Those post-modern learning curves are steep these days.

Anyway, our bosses have chosen to purchase Treo phones for us, which are basically "smart phones" which provide Palm Pilot capability, cell-phone service, alphanumeric paging, as well as the ability to wirelessly check email, write Word documents, alter spreadsheets, carry huge files of medical and pharmacological data, and a gamut of other functions. Contrary to popular belief, these small machines---with thousands of times more memory than the Lunar Module---will be insured, and we providers will not be financially responsible for their replacement if lost. We'll just be summarily fired, no questions asked. (Now that's an occupational hazard!)

The upside is that these devices will eventually allow us to have reams of information available to us in the field as we visit patients at home or accompany them to appointments. We will eventually be able to record vital signs and other data in the phone rather than relying on little slips of paper in our pockets. And when we eventually have laptops upon which we access EMRs (Electronic Medical Records---it's the future, folks!), we'll be able to "sync" the phone/PDA to the computer, share and back up data, and then some. The phone will also serve as a wireless connection to the Internet, allowing us to access patient medical records from remote locations. (So, I'm in a neurologist's office in another city with a patient for a consult, and I need her most recent lab results, and this doc is not privy to our hospital's database. I quickly access my info and---voila!---said information is in my hand.

The downside? A relatively expensive ($500) toy for which I am responsible will no doubt cause this obsessive-compulsive no small amount of checking and double-checking to see if I haven't lost it yet today. Hardware and/or software problems will cause loss of not just one function but many, including appointments and phone numbers, cellphone, and pager. Could be incredibly inconvenient when malfunctioning. Another downside? I get addicted to such a device and feel I just have to purchase one for myself when I eventually leave this workplace. Another? OK, why not? The entire technological infrastructure of the United States collapses overnight when Saudi Arabia and China decide to pull all investment in the American economy out from under our currency. The stock market crashes, the World Wide Web is reduced to a sputtering DSL line in Omaha, and we're reduced to scrawling lab results and vital signs on portable chalkboards. And my Palm crashes and I miss my haircut appointment. Devastating. I could think of others, but that's enough for now. I wouldn't want to look like a technological curmudgeon now, would I?

On the bright side, the on/off button on my (personally purchased) Palm Pilot is on the fritz and the "5" button on my (workplace-purchased) cellphone is pokey. Plus, my pager only receives a percentage of the messages sent to me from the support staff. Now why can't that Smart Phone take a set of vitals?

Adding to the digital fun, I'm now able to fax prescriptions to any pharmacy I choose directly from our hospital system's new on-line prescription function without even having to find the paper chart and record the prescription that I called in on a medication flowsheet. An electronic message is generated which ends up in the inbox of the prescribing doc whose name I used in vain to order said prescription. S/he then digitally "signs" the script after the fact (or comes to find me and wrings my neck for refilling that patient's Ultram again!) An added benefit: when one of my patients ends up hospitalized, all of their meds---refill history and all---are universally available to anyone in the system. Pretty nifty, at least until the system crashes with the economy and we have no paper record. (We may be forced to re-think the whole stone- and-chisel medical record practiced before the time of Hippocrates. I heard that the curved chisel revolutionized the recording of blood pressures. Imagine chiselling 146/80 in Roman numerals!)

So folks, until the digital economy collapses under its own weight, I will play with my new Smart Phone and report to you the vicissitudes and joys of its presence in my professional and personal life. (Do you think I don't use that work-subsidized cell-phone for all it's worth?) When the technological shit hits the fan, I may mourn its passing while simultaneously thinking, "Good riddance to all of that! Now where's my old hand-cranked phonograph? Oh no! I replaced all my old vinyl on CD!

From the technology desk here at Nursing Central, yours truly bids you bon nuit.
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