Jurassic Attitudes about Medical Informatics: in the U.S. Navy?

<style title="owaParaStyle">P { MARGIN-TOP: 0px; MARGIN-BOTTOM: 0px } BODY { SCROLLBAR-ARROW-COLOR: #3f52b8; SCROLLBAR-DARKSHADOW-COLOR: #fafafa; SCROLLBAR-BASE-COLOR: #f7f7f7; SCROLLBAR-HIGHLIGHT-COLOR: #cecfce; SCROLLBAR-TRACK-COLOR: #fffbff } </style><div dir="ltr" style="font-family:arial;"><span style="color: rgb(0, 0, 0);font-size:100%;" >The message below to a listserv for Chief Medical Informatics Officers and related positions was recently forwarded to me by a colleague. I cannot believe what I am reading, as it reflects attitudes I'd thought were extinct by the late 1990's ("I don't see the value of clinical informatics").<br /><br />The last time I'd heard such nakedly Jurassic views, and other anti-physician informatics attitudes <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/informaticsmd/tactics.htm">as in this 1999 essay</a> I penned, was from the C-level officers of the hospital where I was CMIO in that time frame, Christiana Care Health System in Delaware.<br /><br /><br /></span><blockquote><span style="font-size:100%;"><span class="undefined"><span style="color: rgb(0, 0, 0);">From: (Withheld)<span dir="ltr"></span><br />Date: Sun, Jul 4, 2010 at 9:24 AM<a href="http://www.blogger.com/redir.aspx?C=c4065bc8add74dd197a9b92ea9c445cf&URL=mailto%3aAMDIS%40home.ease.lsoft.com"></a></span><br /></span><br />Hi All,<br /><br />I was recently told by one of our senior leaders that </span> <span style="font-size:100%;"><strong>he saw no value to Clinical Informatics</strong> and followed that up by <span style="font-weight: bold;">disbanding the Clinical Informatics Directorate at the BUMED (Headquarters of Navy Medicine) level</span>.<br /><br />I successfully countered that argument with a more senior leader, but I tried to find objective evidence of the value of Clinical Informatics without success. As an academic family physician who lives, eats and breathes evidence-based medicine, I try to make all my decisions and arguments for and against positions/programs based on the best available evidence. In this case, all I could use was potential value and logic.<br /><br />My question is this: Does anyone out there (and I have already discussed</span> <span style="font-size:100%;">this with [<span style="font-style: italic;">name redacted - ed.</span>]) have any objective evidence that shows the value of clinical informatics to the Enterprise (which has multiple definitions, but suffice it to mean across an entire health care system.however large)? I have already talked with [<span style="font-style: italic;">name redacted - ed.</span>] about including a survey of CEO's/COO's/CMO's/CIO's as to the value they see in clinical informatics, but that is some time in the future. I really need some data now. Anyone have anything? Any and all assistance is greatly appreciated.<br /><br /></span><span style="font-size:100%;"></span></blockquote></div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;"></span> </div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;"><br />In the face of the apparent spectacular failure of AHLTA (<a href="http://hcrenewal.blogspot.com/2010/07/4-billion-military-emr-ahlta-to-be-put.html" target="_blank">$4 Billion Military EMR "AHLTA" to be Put Out of Its Misery? Also, Does the VA Have $150 Million to Burn on IT That Was Never Used?</a>), I certainly view such statements as extraordinary, and in a very negative sense.<br /><br />It has become my opinion that Jurassic attitudes about medical informatics are virtually <strong>unremediable</strong>; they suggest an underlying technical and mental deficit in those who proffer such opinions that is not correctible by evidence and logic. (I can predict with a good degree of certainty that this "senior leader" had a role in AHLTA's demise.)<br /><br /></span></div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;"></span> </div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;">I suggest a different approach: surely patients received suboptimal care (and perhaps suffered injury) under AHLTA. The freebie newspapers serving the soldiers such as I have seen in my visits to Fort Dix, where my mother has commissary/PX privileges as a result of my father's service-connected injuries and disability, might find such a story "interesting."<br /><br /></span></div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;"></span> </div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;">In the meantime, I am doing a <a href="http://en.wikipedia.org/wiki/John_Galt">John Galt</a> regarding persons espousing the "I don't see the value of informatics" view. I'm frankly tired that such people remain in the healthcare workforce. While I could provide a lot of material supporting the value of informatics (actually, its essential nature) that I and others have written over the years, I choose to no longer do so.<br /><br /></span></div> <div dir="ltr" style="font-family:arial;"><span style="font-size:100%;"></span> </div> <div dir="ltr"><span style=";font-family:arial;font-size:100%;" >The military person proffering this view is apparently a "senior leader"; it's their responsibility and indeed obligation to make the Navy better. Let them lead.<br /><br />And let the pieces fall where they may.<br /><br /></span><span style="font-size:100%;"><span style="font-family:arial;">-- SS</span></span><br /></div>

Jurassic Attitudes about Medical Informatics: in the U.S. Navy?

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