I started at Albany Medical Center on July 1, 2007, bright-eyed and bushy-tailed, primed to make a difference in the department. Like many other small to medium-sized institutions, I had noticed that the department was somewhat lacking in the technology department. The reason for this, I was assuming was a reluctance on the department’s end, because, let’s face it, most people enjoy the comfort of the status quo. Well, I thought that this was something I would be able to overcome with a little spirit and some enthusiasm. While that may have been true, it turns out, the real reason AMC is technologically lagging has to do with the hospital administration-at-large and not with my department. Part of it is due to our situation- the path lab is owned and operated by the hospital while the pathologists technically practice privately. As a result, all of the major purchases for pathology are handed down from the institution’s higher management; and while the pathologists have some input in the decision making for their livelihood, it is most certainly not absolute.
It was then that I realized how naive I was; I am still not disheartened, just a little surprised at how off-guard I was caught. I have no idea why I thought that I was perpetually carrying around magical red-tape scissors. Needless to say, I still have not figured out a way of getting through to the administration. I’m just a doctor, what do I know about IT? Yea, thanks.
The inciting topic was our AP LIS (the vendor shall rename nameless). Talking to various vendors at this year’s USCAP, I had many interesting and clever solutions pitched to me, from automated processors to WSI education tools. Cool stuff. But the rubber really hit the road when I told them what LIS we used. The most hopeful response was a tacit pause followed by a “Well, we can make that work if you want to…” Super.
Well, I went home feeling sorry for my department and its apparent self-handicapping. At that time, I was attributing the decision to choose our particular LIS as a cost-saving measure; perhaps AMC just chose an inexpensive system to save some money. And then I heard how much installation and monthly maintenance actually costs. As a pathology n00b, it took me a minute or two to get over the sheer sticker shock of medical solutions in general, but then when I calmed myself and placed things in perspective, I was left with a quizzical look upon my face. Implementation of our LIS cost more than double than a quote I got from a popular major competitor. Sure, I’m sure I was under-quoted at the conference, and I’m sure that our LIS came in over-budget in the end, but I had to wonder if this was truly common-place. And for the astronomical price we pay for a service contract, it’s bewildering: (1) how often there are crippling system-wide crashes (2) how long it takes for these issues to be resolved by the company representative.
So why is this OK? Polling of the lab staff and the attendings reveals a near-universal “I hate our LIS”, yet nothing changes! Is there a solution for me? What can I do? Queries to IT result in dismissal; we are committed to this particular LIS come hell or high-water, apparently. I suppose the best advice is to just take a deep breath, forge ahead, and make the best with what you have got…
I just wish I had known that coming into the game. Well, I suppose I have since learned to pick my battles, and have instead decided to focus my efforts where they have a chance of being fruitful- by working to update things on the private side of the practice. Life lesson, learned.
UPDATE: Ha! Bruce Friedman over at LabSoft News posted this today. Interesting companion to this post! Thanks!