Some Thoughts on the Psychology
of Integration of Informatics in
Healthcare; and a Suggestion
Sanjoy Sanyal
MSc student, Health Informatics, RCSEd and University of Bath, UK
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 nonhealthcare 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.
Psychological implications - 2
 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.
Psychological implications - 3
 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
Re-orienting our psychological
personae - 2
 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 (?).
Re-orienting our psychological
personae - 3
 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.
Re-orienting our psychological
personae - 4
 We should not be a copy-cat: Trying to
blindly mimic other healthcare / nonhealthcare implementations.
 Each place has its own unique set of
requirements and resources; system
implementation should match these two
Re-orienting our psychological
personae - 5
 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)
Anamnesis Capture – Potential
Solution
 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
Anamnesis Capture – Potential
Solution
 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.
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Some Thoughts on the Psychology of Integration of