"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Sunday, March 29, 2009

Health Information Technology: Salvation or Termination?

Terminator was a warning: a warning against technology, the government, big corporations and our own proclivity to self-destruction.

Terminator Salvation (#4) is due out in theaters 21 May 2009.

Why is a story about human-like, murderous robots relevant to physical therapists and health information technology (HIT)?

Maybe because health care is the biggest part of the US economy that has resisted innovations in electronic communication and information organization.

Yet machines are increasingly all around us and are becoming more and more parts of our lives.

We willingly adopt machine conveniences that make our lives more and more electronic (like this blog).

Are we afraid?

Are we resistant to embrace electronic communication, data storage and retrieval because the act of using a computer takes us away from face-to-face patient care?


The main reason hospitals and health care providers don't adopt HIT is because of the cost. Health information systems can cost hospitals between $20 million and $100 million dollars.

Only 2% of hospitals, mainly urban, have adopted HIT according to a new study in the March 26 online edition of the New England Journal of Medicine.
“HIT adoption levels are abysmally low in American hospitals.

We have a long way to go to achieve a health care system that is fully electronic,” says lead author Ashish Jha, M.D., an associate professor at the Harvard School of Public Health.
The Terminator is a gory story but the health care dollars are real.

Another reason is complexity.

Health care regulations already overwhelm providers in even the most complex specialties - never mind that general physician practice may be more complicated than neurosurgery.

Whose side are you on: Humans or Machines?

"There is no fate but what we make" - John Conner

I am in the camp that believes automating and standardizing certain aspects of our craft:
  • compliance
  • documentation
  • checklists for the following:
    1. medication list
    2. falls history
  • home exercise videos hosted for free on YouTube
...would enable us to more fully engage and treat our physical therapy patient in the limited time that we have together.

The future of technology should not be about fear and fighting over who will pay for it - ultimately, we all pay for it.

Physical therapists can usher in and lead a new generation of health care providers by learning and using readily available (and often FREE!) tools available on the Internet.

I ran across this pithy quote from James Cameron, the director of the first two Terminator movies, in the April 2009 Wired magazine.
"(Terminator is)...about us fighting our own tendency toward dehumanization. When a cop has no compassion, when a (psychologist) has no empathy, they've become machines in human form.

Technology is changing the whole fabric of social interaction. We're absorbing our machines in a symbiotic way, evolving to become one with our own devices, and that's going to continue indefinitely."

Free Tutorial

Get free stuff at BulletproofPT.com

Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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