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Empathizing Over Paper

July 2, 2008
by Mark Hagland
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A few weeks ago, my trusty old health club died. That is to say, several months after a sleek new health club with all the latest equipment and amenities had opened up across the street, and flocks of toned gym-goers had deserted my original gym for the new arrival, and after the across-the-street new health club had then taken over the old health club, the old gym announced it was closing, and within a couple of weeks, it was gone.

To be fair, there was no comparison, objectively speaking: the new health club has two swimming pools, including a rooftop deck one; a climbing wall; and miles of treadmills, elliptical machines, and stairmasters, all housed in a gleaming multi-level setting that made my old health club seem like one of those sweaty old gyms from the 1960s that were crowded with banged-up barbells and guys named Louie, and that reeked of male aromas. Even my old gym’s name had come to work against it: I’m sure the name Sweat Shop sounded clever 15 years ago, but unfortunately, its various connotations were decidedly less appealing a decade and a half later, with glamorous competition right across the street. All told, it took less than a year for the Sweat Shop to collapse in the face of across-the-street competition. I was indeed one of the last holdouts, most of my fellow “Sweat Shoppers” having already moved across the street to work out.

Still, I did feel a certain sad wistfulness about my old gym the day it closed; the environment there had been casual and familial, whereas the new health club has a rather cold, corporate atmosphere, and no one smiles at each other or chats much. Still, I follow much the same routine as before—I jog through one of Chicago’s beautiful lakefront parks and end up at my new health club, where I do a light weight workout on much the same machines. But the easy familiarity of the old place was exceedingly comfortable, and had I not been forced to migrate (I laughingly referred to myself as “one of the Sweat Shop refugees” when I registered at the new place), I probably never would have.

Perhaps that’s how it feels for many clinicians when they are suddenly yanked into the world of electronic medical records, CPOE, eMAR, and other clinical information systems. There’s absolutely no question that automation is a must if we in healthcare are to achieve the levels of patient care quality, patient safety, efficiency, and transparency being demanded of us by purchasers, payers, and increasingly, consumers. I have to say, I find myself becoming impatient when I hear my primary care physician complaining about the demand that he make his practice electronic, even though he has every reason to do so (including the fact of a two-location practice on the North Side of Chicago, with the two office practices separated by a considerable physical distance).

But for a moment a few weeks ago, as I worked out for the first time with weight machines at my gleaming new gym (the old gym had closed the day before, and I had been one of what seemed like about five people working out there the last night it was open), my mind drifted towards patient care automation, and the feelings a good number of clinicians must have with regard to “giving up” their paper records and going electronic. Automation must happen, everyone agrees; but human beings are creatures of habit. Having lost my health club to the winds of modernization, I could at least momentarily put myself in the shoes of the doctors, nurses, and pharmacists who are being pressed to give up what has been for them a comfortable, if highly imperfect, world.

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