I admit, I am a geek doctor. Started playing with computers about the same time I started university training as a healthcare professional, and throughout my professional career I have used computers, and enjoyed it. Back in the early 80’s we had to write our own programs to make the computers we had do anything vaguely useful. As my first degree was in optometry, and I started practice in 1983 I wrote a program which allowed me to automate the process of sending out reminders to patients who were due for another eye test. Before that we literally went through our files and hand wrote those reminders to patients. It was revolutionary at the time. I even managed to keep a copy of their prescription on my computer, at that time a Commodore 64 and over time was even able to print out that prescription. Seems archaic, but in 1983 that was pretty cool. I started going one step further and doing something we called graphical analysis of patients results, where we looked at the ratio of people’s eye focussing capability to their ability to converge their eyes, looking for latent weaknesses that suggested they would have problems with prolonged reading, or paradoxically it ended up also predicted people who had problems using a computer for long periods of time.
OK, so enough history. Why do I ask if we need more geek doctors. Well it seems our UK colleagues have identified that they need more geek doctors over there. Now to be more polite the preferred term is CMIO, Chief Medical Informatics Officer. It is a term born in the USA, and has been around for quite a while over there. They even have their own professional body, AMDIS, the Association of Medical Directors of Information Systems. I have been fortunate enough to meet some of its members, including Dr Bill Bria and their CEO Richard Rydell. These guys run the Physician Symposium at HIMSS in the USA every year, which is still one of the best events I have attended.
The UK has realised that one of its major failings was not engaging clinicians in implementing IT systems and information projects. The knee jerk reaction was to hire some, and assume the job was done. Whilst some of their hires were stellar folk, I include Dr Mike Bainbridge and Dr Simon Eccles amongst those, it was a stop gap measure. Unfortunately here in Australia we seem to have similar issues. At a national level we have Dr Mukesh Haikerwal leading the clinical leadership team at NEHTA, and I am the first to say he is doing a great job. He has a group of able clinicians in his team, albeit mainly unpaid volunteers from what I have seen. However when you go down another layer there is a distinct lack of people with clinical background or credentials involved in the delivery of health related IT systems. In actual fact, if you survey the geek doctors out there, many of us are working in industry, some of us not even in the health IT related industry. There are some exceptions, and I hope they don’t mind me naming them. Dr David Doolan in the Hunter region of NSW, Dr Craig Margetts in Queensland, and Victoria even has a doctor as their health CIO in Dr Andrew P Howard, as did Westmead Children’s Hospital for a number of years in Dr Ralph Hansen. However the bulk of healthcare entities do not have an official geek doctor, who sits at the right level to advise and be involved with ehealth projects.
I recently did a 2 week course over at the Harvard School of Public Health on IT in healthcare, and was astounded by the sheer volume of geek doctors in and around Boston. People like Dr John Halamka, Dr Blackford Middleton, Dr David Bates, Dr Ashish Jha, and very many more who have active roles in determining the IT strategy of their organisations, and in some cases the whole country. They had instituted proper training programs for doctors and other healthcare professionals to go through to become official geek doctors. They had structured career paths that these geek doctors could follow. It was geek doctor heaven.
So to answer my own question, I believe we do need more geek doctors, or Medical Informaticians if we want to be pedantic about the name. We need to make it a career path that our brightest students can consider. I have a son doing his HSC this year, and as we look at what courses he can do next year at University, he asked me how I ended up where I am. There were no courses for geek doctors then, and even IT wasn’t really taught at University in those days. Now he can choose to do IT or healthcare but there still doesn’t exist a path to do healthcare IT.
So if you are a geek doctor and have an opinion, let me know. If you think I am just looking for my next job and that geek doctors are not needed let me know. But let’s start the discussion before it is too late. Let’s not let all our good geek doctors be hired by the USA and UK who have recognised the need for them.