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The Automation Quandary

September 1, 2010
by Paul H. Le
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Providers must separate wants from needs when examining technology

Nothing is wrong with paper and pencil. There, I said it, after more than 10 years of helping addiction and mental health professionals assess technology needs and feasibility. I admit that paper and pencil may tip the scales on technology for cost. Arguments can be made on both sides for convenience, transportability and practicality. But when it comes to efficiency, technology is hard to top.

Efficiency is critical in most clinical settings-for good or bad. Ensuring everyone's on the same page regarding client treatment plans, schedules, etc., is important. It ranks right up there with making sure the coffee station is stocked.

Clicking a button and having instant access to a client's treatment plan-to know progress or anything else, anytime-has value. Technology enables clinical staff to perform certain tasks with more efficiency. It doesn't guarantee success, of course, but the right “solution” used the right way leads to good things.

So the question really isn't whether technology can be helpful. More often, I find people asking what technology would work best for them. Whether for a counselor assessing clients from a small office in an outdoor strip mall, or for an entire county of treatment providers, there is something out there that can work. But to make matters frustrating, today there are about as many technology options as there are choices in the salad dressing aisle.

Help is here. I'm not selling a be-all, end-all method for selecting the right technology, but I am willing to share what has helped me and many others: Keep…it…simple.

In order to figure out what technology suits you or your organization's needs:

  1. Write it out-what you have, want and need.

  2. Understand the options-what's out there and how do I know it's right for me?

Write it out

First, write out what you already have-for documentation, tracking, planning, scheduling, reporting and so on. You may already have a clinical management system, use MS Word, or rely on paper and pencil.

Again, keep it simple. Are you dissatisfied? Write out the reasons and then push yourself to answer-honestly-if they justify change. Most likely, some will and some won't. The following list offers examples of some scenarios:

  • “I already have a solution/system in place, but it doesn't seem to do what I want.”

    Does the solution really fall short, or do you not understand its capabilities? And is what you want really what you need? Be honest before upgrading or swapping.

  • “I'm fine with using paper/pencil to work with clients. I'm sure software would help, but I doubt I can afford it.”

    Embrace the golden rule: If it ain't broke, don't think you have to fix it. However, if you think “software” equals “better services for my clients,” then it might be worth looking into-especially if it can be more cost-effective. There are numerous programs out there (Web-based, specifically) that cost only a small monthly fee. Think of it this way: If you assess only one client a month, that cost alone easily could pay the monthly fee and more. And quality systems at that cost do exist.

  • “We're forced to use a system for state/federal/contract funding that is critical, but it lacks clinical relevance. So we use another system to handle our case management.”

    This is another all-too-common, legitimate complaint among addiction professionals. Work with the software vendor and the state on interoperability solutions. Most state/federal systems have the capability to work with third-party vendor software systems, which might allow you to reduce duplicative data entry. And remember, technology people love to solve problems, innately.

  • “My facility doesn't use any software system at all. How can I expect to purchase and implement a full electronic health record?”

    Not everyone needs to implement an EHR, at least not right away. Legislation will go through modifications, and regulations will change. However, it is only natural that other payers will start requiring that some form of technology be used in the years to come. For now, even if you start with a small system that fits present needs, that can prepare you for the future.

“Wants” are “nice-to-haves.” And while they aren't necessities, they are important. Wants (like needs) should be prioritized. Make them known, up front, because you will be frustrated if, after a long and costly implementation, you're disappointed to realize you've gotten what you need but not what you want. Put them out there, but be clear and honest with yourself that these are wants.

Last February, after presenting at a conference, I was approached by a clinician in a quandary, who said, “Paul, I saw 10 different vendors [at this conference] selling [automation] systems from $500 to $500K, but I don't know what's right. I'm in private practice with a few other clinicians and we know we can improve workflow and documentation, but I don't know what we need.” I encouraged her to write out her goals, following the steps already outlined, and then helped her prioritize what they needed.

Confusion is natural when what we know to be our needs doesn't match what others say our needs must be. These others could be consultants, trainers, regulatory entities, parent companies, peer organizations, friends, family and, yes, software vendors. Expect more confusion if technology experts are combining “need” talk with technology mumbo-jumbo. Technology is meant to provide a benefit, not a headache.