Ticket for the IT train

The train is coming down the tracks. We know this because we can hear the whistle in the distance. What we don’t know is how fast it is moving, how big it is, and exactly when it will arrive in the station. More importantly, we have not yet been issued a ticket to get on board, and without the right key to the stateroom and the right luggage to carry our necessities, the journey ahead is going to be difficult and complex.

What am I ranting about and what relevance does a train have to the current state of health care in BC? Information technology (IT), and believe me, it’s big and moving fast. There is an increasing focus both in Canada and worldwide on the need to improve the efficiency of health care delivery and IT is being recognized as a critical building block to make this happen. This will be seen as a pivotal year for information technology in health care in British Columbia. At a national, provincial, and regional level, the stars are beginning to align as we collectively recognize the importance of a mechanism to deliver enhanced quality of care by providing the right information at the right time to the right person.

In January 2005 a team of physicians, ministry representatives, project leaders, and business analysts released a comprehensive Primary Care IT strategy for Vancouver Costal Health. As one of the lead physicians for the strategy, I have had the opportunity to lead the Vancouver Coastal Health Physician User Group strategy. The Vancouver Coastal Health Physician User Group (PUG) Strategy is intended to facilitate the creation of geographic, special interest, and ultimately virtual groups of physicians using electronic communication tools to share information between one another and with the health authority. At the time of writing this editorial, seven groups have been established, and by mid-June 2005 each of those groups will have had an initial meeting.

Through these meetings it has become clear that one of the challenges we face as physicians is a loss of collegiality. Not because we’re bad people or have any less respect for one another than we did in the past, but because in many communities we have lost an important physical setting—the doctors’ lounge. When the majority of physicians in the community had hospital privileges, an important part of the day was visiting the doctors’ lounge, picking up one’s mail, and spending a few minutes socializing with colleagues. Not only did this communication keep the system running more efficiently (it was possible to arrange a consult for a patient with a 15-second conversation rather than multiple telephone calls and faxes), but it was an important part of the social fabric of the physician community. Our doctors’ lounge no longer exists and I miss it. Many primary care physicians are no longer affiliated with the hospital and as a result have limited direct contact with other physicians in the community—or may have no contact at all. How then do we let these physicians know about the changes taking place within the province, the region, or the community? How will they know when it is time to get on any number of trains that represent the sweeping changes due to take place in health care in the next decade if there is no mechanism to share that information locally and in a manner that is relevant to us in our specific communities?

The Physician User Groups are one mechanism that will help bridge the communication gap and will use the Internet, e-mail, and virtual communication tools to support one another and recreate a meeting place, a virtual doctors’ lounge. This will give us the opportunity to view information, share ideas and thoughts when appropriate, and more importantly, participate when it makes practical and business sense to do so. There is a sense of inevitability that the information technology train is coming and when it arrives in the station, I don’t want to be standing alongside the tracks blindfolded and without a ticket.

—AJB