Sunday, August 19, 2018

Across America there are healthcare IT professionals who spend their days debating the value of certain kinds of technology in medicine. Take electronic record-keeping as an example. We assume electronic records are good for everything from emergency medicine to family practice. But are they? More importantly, is every piece of technology introduced to healthcare truly beneficial?

Nowhere are the ups and downs of healthcare technology more observable than in the emergency room. This is where the rubber meets the road, so to speak. It’s where life-and-death decisions are made at a moment’s notice; where doctors and nurses have to rely as much on gut instinct as the knowledge they possess. Technology helps them in some cases yet harms them in others.

The reality of technology in emergency medicine is that it can be both good and bad. To illustrate the point, this article takes a brief look at two articles published by Emergency Medicine News in March.

The ED Callback Goes High-Tech

In the first article written by Dr. Alex Mohseni, we learn of a cloud-based service designed to improve how emergency departments follow up with patients. For the record, research data shows that EDs with aggressive callback policies achieve better outcomes. The problem with callbacks is time. Emergency medicine doctors, be they hospital employees or locum tenens physicians, barely have time to attend to the patients they see every day. Doing callbacks adds to the work load.

Mohseni explains that the platform as one that uses a cloud-based app to handle many of the tasks a traditional callback is designed to accomplish. Patient data is entered into the database upon his or her visit to the ED, then the patient is encouraged to remain engaged after leaving the emergency room with the use of a mobile device or a wearable.

The software can be used to track all sorts of vital patient information. Doctors can even create ongoing treatment plans and certain milestones they want patients to reach in the recovery journey. They can essentially use the app to continue engaging with patients without having to call them on the phone. This is a case of technology improving emergency medicine jobs in a way that benefits both doctors and patients.

The Video Interviews for EM Residency

The other side of the technology coin is represented in an article written by Dr. Thomas Cook. In his piece, Cook explained how a growing number of emergency medicine residency programs are now requiring applicants to complete a 15-to-20-minute video to submit with their applications. Applicants are given a series of questions to answer on camera, with the idea being one of measuring their ability to work under stress by putting them in an uncomfortable situation.

Cook makes the argument that the application process for emergency medicine residency is already complicated enough. Applicants fill out dozens of pages, compile all sorts of documents, and expend untold amounts of energy trying to convince program directors they have the right stuff. Adding a video to the process seems a bit excessive, according to Cook.

Cook also makes a good case that poor performance behind the camera is not necessarily indicative of an inability to interact with patients. He thinks requiring videos as part of a residency application is a bad idea.

The debate over technology in medicine isn’t likely to end anytime soon. But at least we can agree that not all technology is good or appropriate for every environment. There are some technologies medicine cannot live without; there are others we really don’t need.

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