Over the last several months we've had the pleasure of sharing our thoughts about information technology and informatics through presentations at meetings, articles and conversation with colleagues. The response has been astonishing. We've been accepted, rejected, encouraged and discouraged in our pursuit to educate others and share our vision about the inevitability of information technology as a necessity for the survival of our field.
Often those who are most critical voice their opinions without any other direct experience than dealing with the local automated teller machine or seeing their son or daughter at work on their own home computer. Nevertheless, such critics have extremely strong views about why information technology is bad and should be avoided. It is our view that such opinions are based on ill-formed fears.
In this article we hope to deal with these fears. They are usually based on myths that often contain a grain of truth. These myths are the real barriers information technology faces, and they have contributed to the problems that have been encountered in its acceptance and development.
Myth No. 1.
I don't need computers in my work. There is some truth to this. Paperwork done in association with clinical care has been and can always be just that-paperwork. Computerization is not required. The falsehoods of this belief are the assumptions that information technology impacts only documentation and that our clinical work will continue to consist primarily of direct delivery of care. Patient contact is changing! Managed care and other market forces will continue to result in our doing less direct care and in making us more peripheral.
We will be asked to manage a growing number of cases that require our knowing patients yet seeing them less. We will need improved communication tools to keep us in contact with colleagues providing care, and data bases to track and manage our caseloads. We will need to constantly deliver information to utilization reviewers and managed care supervisors. It may be that some individuals can escape the onslaught of managed care and the information era by restricting or moving their practice. The majority, however, will need computers and computer training not just to prosper, but to survive.