psychology of informatics integration in healthcare

Some Thoughts on the Psychology of Integration of

Informatics in Healthcare; and a Suggestion

Sanjoy SanyalFormer MSc student, Health Informatics, RCSEd /

University of Bath, UKPresented @ Middle East Conference in Health Care Informatics

Dubai on 10th April 2005

10 April 2005 MECHCI 2005 Dubai

Financial Constraints in Healthcare

Available resources are always several paces behind the demands on healthcare.

Whenever national budgets need to be revamped, healthcare sector is among the first to receive the axe.

When budgetary allocations are considered, healthcare sector is among the last in the dole list.


General Constraints in Healthcare

Healthcare facilities are often understaffed and under-equipped; providers are generally over-worked.

Wide inter-regional and international variation in scope and depth of healthcare infrastructure

Healthcare sector lags behind non-healthcare sectors in IT implementation


Psychological implications - 1

Feeling of being left behind by the world

This has served to make many of us go on the defensive, even bordering on the diffidence.



As a belated knee-jerk attempt to catch up with the Joneses…

We are engaged in a race to anyhow implement informatics in healthcare, often without proper background study.



Smarting from this state of affairs…

We are unconsciously trying to mimic other disciplines in our attempts to integrate informatics in healthcare.


Mixed Psychological Interplay


Re-orienting our psychological personae - 1

We should not flog a tired / dead horse: When a system is in its death throes…

Should have the wisdom to recognize it Should not throw good money after bad Have the humility to admit our faults, learn

from our mistakes, cut our losses, and plan again more rationally for the future…

With a balanced perspective



We should avoid being a “me too” chick: Implementation of a system should not be just to say, “We also have a system in place.”

Is this what we want or need (?) Is it benefiting our patients (?) Is it supporting providers in their work (?).



We should not swallow more than we can digest, like boa constrictor:

Informatics plans should not be overambitious and grandiosely expensive

Should be just right for the POC Requires possessing the right perspective

of the magnitude of the problem.



We should not be a copy-cat: Trying to blindly mimic other healthcare / non-healthcare implementations.

Each place has its own unique set of requirements and resources; system implementation should match these two



We should not get into a rat-race: Non-healthcare domains are way ahead, or Other healthcare facilities have expensively

computerized their activities These should not be deciding factors in our

decision to do the same with our POC.


Communication and Patient Anamnesis

Diversity of information Ambiguity / confusion of classifications

and terminologies Problems of data entry Problems of interpretation of coded data Importance of, and problems in,

anamnesis capture


Anamnesis Capture

Computerised voice dictation system: Logical progression from Dictaphone,

but… NLP is still in infancy Mainly operational in X-ray reporting

environments with a keyword macro-type language.


Anamnesis Capture – Potential Solution

Record and store spoken word directly into the EPR

Capability is available now; may overtake quest for converting spoken word to text

Lateral thinking is needed. Patient communication (a la humanities /

social sciences) can be included in DV format (reduction in cost of multimedia, increasing versatility)



Instead of trying to ‘code’ patient narrative, capture anamnesis in audio/audiovisual files

Break into smaller manageable sections, with hyperlinked subheadings, and store

Click/point on relevant linked subheading to see / hear patient anamnesis recording



4GL multimedia compiler (for audiovisual anamnesis), which would be compatible with most of the common OS in PCs


Multimedia Compiler – Features

Audiovisual anamnesis, database systems, patient data banks, knowledge transfer / complex tables, PC technology for video/screen titling, synchronization

Multimedia translation PCs / "speaking" question catalogs in different languages (digit interpreter)

Representation of logistic operational sequence, process animation and visualization


Multimedia Compiler – Network and Control Systems

Information and control systems for hospitals Multimedia information networks Network communication in hospitals, multimedia

patient information Radio data base access on central server Global data base accesses by Internet (‘intelligent’ /

associative term search Internet video-phones / full-duplex video conferencing


Conclusion – 1

Healthcare informatics implementation: Complex entity without any comparisons with other domains

Socio-cultural Psychological Technical Commercial Political


Conclusion – 2

Patient anamnesis audio/audiovisual capture

The theoretical perspective should form a test bed for practical validation through collaborative research.

psychology of informatics integration in healthcare

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