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Passive or Active (not RFID)

September 1, 2008
by Anthony Guerra, Editor-in-Chief
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Sometimes CIOs need to speak out against technology

KANSAS CITY — As I fly back from a journalism conference, I feel a bit of weight on my shoulders. You see, not surprisingly, I spent the last few days having the “online is the future” message drummed into me. Now, don't get me wrong, I am wholeheartedly a believer that such is the future of publishing, and I feel we've made tremendous strides at HCI Online, launching over 15 guest blogs, and more than doubling our Web traffic over the last year.

But some of the “bells and whistles” being touted at the conference left me skeptical. Video, for example, sounds exciting, and I'm sure we will come up with some good ways to leverage that medium on our site, but there's also an ROI question that needs to be considered. For example, what's more useful to our readers? One video-taped interview or five print interviews? Sometimes, the farther you go into the bells-and-whistles strata, the greater the resources needed to produce it.

My job, as editor-in-chief, is to make sure we're making sound decisions about the use of our time, money, and energies; that we're serving you and not just having fun behind the scenes trying out new bells. My guess is that the patients coming into your facilities expect the same.

What brings this idea to mind, for one, is the wave of check-in kiosks being implemented at hospitals across the country. Kate Huvane, our associate editor, has written a story on the subject for this issue. As I write this memo, I don't know what the findings of her story will show, but I've got plenty of questions about this particular use of technology in the healthcare setting.

To me, a hospital is probably one of the last places I'd want to lessen the human touch.

Automated systems, like ATMs and phone trees, lend themselves to certain types of interactions. When it comes to withdrawing cash, the technology is almost perfect, as very few questions accompany the need to take $100 out of an account. When it comes to printing a boarding pass, again, not much to discuss.

But when it comes to other types of services, phone trees and automated responses cause more customer-service harm than good. For example, ever tried to get someone on the phone at your medical insurance company to discuss a denied claim? You wind up needing medical service after the call, as unwieldy phone trees seem specifically designed to inflict emotional distress. Discussing a medical claim is the type of interaction with a million different flavors, and usually a distraught person calling in (“You mean that $3,800 is not covered?!?”).

When it comes to checking into a hospital, even for a scheduled procedure, I place that interaction among the latter types. Oftentimes, those checking in are older, less comfortable with technology, and frankly, scared. What they want is to be immediately comforted, treated gingerly, and reassured (about both the clinical and financial aspects of their stay), not to navigate an unfamiliar machine.

Part of the value in implementing kiosks in airports and banks is that although people fumbled the first few times, they used the machines over and over again. The second and third times around, the companies finally saw the improved efficiency originally promised. Will it be the same with hospital check-in kiosks? Will efficiencies be found only among “repeat” visitors?

If it ever was, the CIO role is no longer just C in name. The position is truly strategic, firmly entrenched among the CEO, COO and CFO as the power players in a hospital. It's important you act like it. Never be a rubber stamp for the technology request of others, as you'll be selling your position and yourself short. If you believe in it, support it, but if questions linger about the direction a certain technology is taking your institution, speak your mind.

Do kiosks constitute the kind of technology taking hospitals in the wrong direction? I'm not sure. It's up to you to decide if they represent a step forward, or merely another bell and whistle.

Anthony Guerra, Editor-in-Chief
Healthcare Informatics 2008 September;25(9):8

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