The Growing Hospital Computer Information System Cannot Be Stopped! by Stephen Mussey MD
A funny thing happens to a hospital information system over time. Old technology is only partially retired. Since these outmoded, old systems still retain vital data which is difficult to import, they must remain active and cannot be disconnected. In a few years, additional systems are added from different software and hardware vendors. Again, the older programs and hardware can never be fully retired so they continue to run amidst the information infrastructure.
Soon, the information technology contains multiple generations of complexity, all attempting to work in harmony.
In time, the folks who supported the older systems retire or die of old age, but their legacy computer software and hardware live on because they still contain necessary data and act as a key bridge for certain functions.
A few years later, even newer hospital departments add their own special health records software, crudely attached to the main software and hardware systems.
All of this must be accessible remotely, so someone contracts a company to write special code to tie some of the systems together, but they never really work well together and frequently crash each other. The additional code has the perverse effect of integrating the obsolete systems into a vital support beam of the computer infrastructure.
Unplug an older obsolete technology and the whole system collapses.
Meanwhile, old style dictation typists must input their reports, though they are badly converted and assembled with the newer technology. In back rooms, ancient vacuum tube devices continue to glow, supporting long forgotten functions of the master computer.
Before anyone notices, the hospital information complex is now three decades old and no one has a clue how it all works. It becomes a money-eating organism which expands in a modular fashion, gobbling department budgets and occupying more employees.
Someone shouts: “We need to integrate an ACA community health record!” and the massive grinding structure quickly triples in size at enormous cost. The overwhelmed hospital finally declares bankruptcy and sells out to another healthcare entity. The workers and ownership change, but the data-churning monstrosity does not miss a beat as it continues to expand, integrating and absorbing the new owner’s computer system.
It is too late! Nothing can stop it!
Run for your lives!!!!
Our current system of medical IT resembles a crazy wino living in a refrigerator box, who collects string and bottlecaps, under the hypothesis that when string, or bottlecaps, are desired – then he will have cornered the market on them.
Of course, there’s no room to keep it at one’s residential refrigerator box; he has a secret cave which stores the Great Ball of String, and the bottlecaps. He knows that when they are wanted, they will have to come crawling to him.
Nobody wants the vast majority of Big Data, and nobody ever conceivably might want it. It is not cataloged or sorted for precisely this reason – since it has no value, it has no valuable attributes by which to characterize it. It might be “data-mined” to determine the average grandmother’s shoe-size by some university researcher, someday. It can be squeezed for publications. But it should be called a Data Midden, not a database.
Information is an instrument to be used by the mind. Nobody gets that. Some of the self-appointed Mister Peabodies of healthcare IT envision an app that can transmit vital signs real-time to a doctor. For what purpose, nobody knows. Vital signs are useful unless when they are useless – only a trained mind might be able to know the difference.
Nevermind. When they come looking for bottlecaps, the little tramp will be on Easy Street.
Sounds like a good basis for a med tech thriller set in the not too distant future. Could this be hacked by someone in the illicit human organs market, searching for possible clients?