I have a good friend from my undergrad college days whom I'll call “Linda” (not her real name). Linda grew up one of 10 children in a small Midwestern city. She came from an education-focused, highly motivated, but cash-poor, family. And she and her very intelligent sisters were all determined to never end up as secretaries. So Linda and several of her sisters made the decision, when the time came, to refuse to take typing classes in high school, in order to avoid that fate. So what happened? When she got to college, Linda ended up having to pay other students to type up her papers for her. And of course, within a few years after that (yes, I'm in my late 40s, so college was in the late 70s and early 80s), the computer revolution came along, and since then, all anybody ever does nowadays is … type. (By the way, Linda ended up as a successful professional, but continues to be hamstrung, on a personal level, by her “strategic” decision of so many decades ago. Oh, Linda!)
How many of us can cite examples at least somewhat analogous to Linda's, in our world and in that of the people we know personally? The world keeps changing, and the pace of change, whether technological or societal, is breathtaking, and seems to be ever-accelerating. I remember 20 years ago in healthcare, when the role of the CIO was first emerging in its currently recognizable form; and I recall the debates and discussions over what a chief information officer was or should be. As we all know, the vast majority of first-generation CIOs were technical people who came up through the ranks, and ended up with shiny new titles and the responsibility of automating their hospital organizations as our industry began its Information Age in earnest. Few of the first crop had the management, education or training to do what they needed to do next. Nonetheless, they were pressed into duty by organizations desperate to establish and extend much-needed IT strategies at a time of rapid technological change.
Fast-forward now to 2010, at a time when change in healthcare, some of it technologically-driven and some of it riding on other waves, is once again rearranging the map of the IT professional world. As EMRs become universal, the old “medical records” profession has morphed, appropriately, into health information management (HIM). And the lines between HIM and IT are increasingly blurring. Meanwhile, virtually every biomedical device in today's hospitals has become computerized, necessitating device-EMR integration at increasingly intricate levels. Not surprisingly, HIM and biomedical engineering are areas that more and more often are coming under the aegis of the CIO, as are such seemingly far-flung areas as materials management and new construction planning (see our cover story, p. 12).
What will happen in the next few decades? Technological and societal change are a given. As a result, healthcare IT professionals need to think as broadly and strategically about the future of our industry, and their role in it, as possible. My key takeaway? Don't be a “Linda.” Decades from now, we'll look back on this time just as I look back on the world of my high school days, astonished at the pace of change of all kinds. So be ready: the map of your world is bound to change.
Mark Hagland, Editor-in-Chief Healthcare Informatics 2010 April;27(4):6
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