Hospital IT from the patient's perspective

by David Orenstein free-lance writer

Back in March my wife and I had our first child, a boy. Amid all the joy and sleeplessness during our four-day stay at the hospital and co-located nursery, I pondered my new family’s collective role as “patient.” Information technology played a subtle role throughout. Consider this a patient’s diary on technology after four days of American hospital care.

Although Sequoia Hospital is on the northern fringe of Silicon Valley, little of the technology there was “in our face.” By far the most visible technology in my wife’s room and in the nursery was the monitoring equipment. As soon as my wife was in her room, she was on monitors that tracked her contractions, her blood pressure, and the baby’s heartbeat. I was intrigued to see that these systems ran Microsoft Windows, which only recently has become stable enough to run something so vital. I mused, however, that it was no surprise that the hardware in the Lucille Packard Children’s Hospital Special Care Nursery exclusively was Compaq and Hewlett-Packard (yes, those Packards are connected).

There is no question that a big part of the reason computers seemed so peripheral to our care (even though one was on every desk, at every nurse’s station, and in every room) is that the hospital staff seemed well-trained to use them. Only once, when my wife was in the recovery room after her C-section, did a nurse err. She apparently began entering all kinds of details, only to notice that she had selected the wrong patient. The error was mild, easily noticed, and easily corrected (as far as I know). As I ruminated about how well the staff members seemed to be trained on computers, I realized that their training made me feel more comfortable as a patient. I could imagine a harried staff in a busy maternity ward or nursery mixing up electronic prescriptions or mistyping data. Even if no data catastrophes took place, would I want my wife and child under the care of frustrated, grumpy nurses? The nurses generally made it look easy, and that put me at ease.

While I appreciated that information technology was not imposing, I found that its presence actually was a little too subtle. Electronic documentation, for example, seemed still to be in its infancy in the maternity ward. Despite all the computers, we still accumulated a fearsome stack of papers from the hospital, the nursery, and relevant private practices. My wife and I pined to have all these documents on a CD-ROM or a Web site rather than in an unwieldy stack. Access to the Internet for e-mailing a few photos wouldn’t have hurt, either. Family clamors for information at a time like this, and patients want to give it to them but don’t have much time to do it.

Still, if the medical motto is “First, do no harm,” there is no point in hospitals spending millions on technology if it doesn’t make operations more efficient. The efficiency of automation in the billing departments we encountered along our journey to parenthood is a case in point. Stanford University Hospital (where we received some prenatal treatment) has computerized systems, but it might as well have the bills hand inscribed by medieval monks. Two weeks before delivery, we received the bill for a procedure that was performed proximate to conception. Whatever those systems do for Stanford, they do not necessarily speed things up.

Meanwhile at Sequoia, human confusion and the resulting misguided querying of the wrong insurance database resulted in a bizarre epilogue for our pregnancy: We mistakenly got the $37,000 bill for our son’s delivery. Rather than pay it, I plan to blame computers.

David Orenstein is a technology and business writer in Silicon Valley. To learn more about a technology topic in Computing Care, e-mail him at davealli@comcast.net.