The publication has lit fires across the Internet and Blogsphere; clouding conversations about Alberta Health Service's (AHS) upcoming clinical information system (CIS) implementation.
Dr. Gawande's writing resonates with widespread frustration among American physicians, channelling anger about decreased physician satisfaction with today's experience of health care. Memorable quips, such as "revenge of the ancillaries", add to free-floating anxiety about the collateral damage brought by enterprise electronic health record (EHR) initiatives.
Connect Care bears no illusions about how its CIS could impact physicians. We have gone to great lengths to learn from the unanticipated and unwanted struggles of others. We continue to study the fears of our own physicians. Indeed, much of our planning turns on harms-reduction, including careful mitigation of four major harms explored by Dr. Gawande:
- Increased Complexity,
- Decreased Control,
- Decreased Clarity, and
- Increased Brittleness.
We'll expand on each of these in upcoming postings. Thanks to all the AHS ACMIOs, physician design leads, directors and analysts who help with these reflections.