Sunday, February 14, 2010

Keeping up with technology: know the answer to the question before youask it


brontosaurus, originally uploaded by eaglewithbars.

In the last year I have begun to have the unsettling epiphany that what I had come to believe was a realistic, successful, and comfortable managerial style has since become as obsolete as the last brontosaurus that took the long walk to the La Brea Tar Pits!

Like any other technologist that has evolved into a more managerial role, I have found that as I have gotten older, I have had moments of reflection at all the new technology continuing to flood the market. You worry that all the new technology is passing you by. Your staff is enjoying the new world of computerized testing and advances and is picking up those talents faster than you can keep up. Guess that's the part of "passing the torch" that comes with the territory.

Framing the question

But what I have found has become even more concerning about all this new technology is the fact that if you don't know the answer to the question you want to ask, you can't ask the question to get the information you need to stay out of trouble!

That might sound foolish, because the very reason you ask a question is because you do not know the answer, and you are seeking information. I think I can safely say that you, like me, dislike people that ask rhetorical questions. But, think back over the last year.

Have you ever had this occur: you take your computer to the "big box" store because it is giving you an error code that has you totally stymied. You find the expert that is going to help you out with the problem and ask the most basic question there is: Why is it giving me this error code? Putting the proverbial pencil in your eye soon becomes a welcome experience after 20 minutes of an advanced dissertation on computer error codes.

At this point, I find myself morphing into my mother--holding my hand up like a school crossing guard and saying: "No--I just want to know why I got the code."

With a slight exhale, the expert begins to explain to me again--slower and slightly louder. After listening to a slightly different version of the original answer, my eyes glaze over and I sign the contract that will allow them to revise my database and find out what caused the code.

Then, $200 later, I have a seemingly new hard drive, and inner peace, until I shut the computer off. The next time I restart it, I have the error code. When I call and state that I have the code again, the agent tells me "Oh, you also need an XYZ update to ensure that doesn't happen every time." I ask why no one bothered to tell me that before and the response is "because you didn't ask us to do that!"

Because I didn't know I needed it, I didn't ask for it, and therefore, I didn't get it. My concern is that I am now experiencing this process in our clinic! What makes this twice as scary is that the above "not knowing" is what we are facing in regards to electronic health records (EHR).

Before you say: "Oh boy, here we go, another tirade or resounding backing of EHR," I would like to share the questions I have learned the hard way in the last year.

I have come to the realization that in the world of computer conversions, EHR, PQRI, and red flag alerts, I am truly "just a tech" and don't have the knowledge to ask the appropriate questions to get the answers that will keep our practice out of hot water.

When we were embarking on an EHR system for our clinic, we extensively researched other groups that were using multiple EHRs. When I got the clinic manager alone for a little tech talk, a recurring theme kept coming to me. And I missed it! Most of them were not clinical/staff managers any more. Their role had been morphed into the "new" office IT manager since the conversion. This occurred because their role during the conversion was to ensure that the doctors and the technical staff were totally ready to use the computer. And I can now assure you, since our conversion, I know the difference between a computer error, a server error, an EScripts error, or something to do with our local carrier. Here's the sad part--I don't want to have this knowledge!

Some observations

So here is what I want to share with you. Take it to the bank!

* You need an on-site IT person that knows the difference between an error, a code, and a hiccup. Expecting non-computer managerial staff to have the answers is going to put you in hot water when the system has a problem.

* Make sure your off-site computer company that is "watching you 24/7" is really watching your systems. Ensure they have access to your sites after hours and keep things running behind the scene. Monday morning is not the time to find out the servers went down Saturday afternoon. And make sure you are their number 1 priority, not number 23 on the list.

* Depending on the number of employees in your office, you need to have an internal response team with a hot-line phone number that your staff can use to get an immediate response to computer issues. There will be issues--no computer system is perfect!

* You need a back-up computer system for your EHR, and it should be in a place that if the main system goes down, it will not take out the back-up system.

* And--make sure the back-up system is actually installed AND plugged in!

As I have learned, I am just a tech. I am not a computer geek. What I have learned this past year is only a harbinger of what is coming. The good side? We have learned a number of valuable lessons and have learned how to ask better questions.

The bad side? You let me know! By reading this, you have just taken your first step to La Brea! Come on in--the tar is fine.

Modern Medicine NETWORK


Read Graves' observations on asking questions about taking stock of where we have been and where we are going at



Thinking ahead during bad times can help you prepare for the next time. See Graves' suggestions on how to anticipate problems at

Take-Home Message

Asking the right question is often the key to finding out what you need to know.

By Dianna E. Graves, COMT, BS Ed

author info

Dianna E, Graves, COMT, BS Ed, is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983. She can be reached at

Source Citation
Graves, Dianna E. "Keeping up with technology: know the answer to the question before you ask it." Ophthalmology Times 34.22 (2009): 43+. Academic OneFile. Web. 14 Feb. 2010.
Document URL

Gale Document Number:A215924928

Disclaimer:This information is not a tool for self-diagnosis or a substitute for professional care.

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