Now we’ve known for a while that physicians interrupt patients faster than you can say . . . well, it’s that fast, about 18 seconds or so. For residents (doctors in training) it’s about 12 seconds. They slow down as they get older I guess. Only a quarter of patients seen are able to complete their opening statement of the problem which, in itself, lasted around a minute.

Since Hippocrates the sign of a good physician (at least to other physicians) was the ability to diagnose the patient’s problem without them talking about it at all. So we’ve made some progress. Maybe.

Ok, this is very old news with medical schools for years trying to teach students to listen more to the patient. And, as stoic patients all, we’ve accommodated the physician know-it-all syndrome as best we can, figuring that it’s the least of our problems or we wouldn’t be sitting on the exam table in the first place. Of course we’ve also had to put up with poorer outcomes as a result as well.

But no matter, for now the folks that bring you health IT want to know more about the role of physicians (and nurses) as “initiators of workflow disruption.” Thanks to an article by Neil Versel at Digital Health Care and Productivity.Com, we hear about the Third International Conference Information Technology in Health Care: Socio-technical approachesheld last month in Sidney where academics have been examining the interaction between people and technology.

According to Tip Ghosh (University of Nevada, Las Vegas, School of Public Health) “the big thing is that it’s about people.”He believes 80% of health-IT implementation failures are attributed to social and organizational factors. Too many other groups gloss over this reality, he maintains.

“We do need to understand why people interrupt, especially in face-to-face communications,” said Juliana Brixley (University of Kansas School of Nursing) who presented the paper on interruptions. She cited research from the business world showing that software engineers need 15 minutes to get back to what they had been doing following an interruption. “In our field, we may not have 15 minutes to return to task.”

I take it that the task of future health IT will be to try and reduce the productivity disruptions in patient care caused by staff interruptions. Well, if we use Brixley’s proxy measure in today’s physician office, and if diagnosing the patient is part of the workflow, the visit is over before its even begun.

Good luck on that one.

There is an entire field of study on interruption management which can be helpful here. But I’ve also come to an appreciation over the years of the theory of management by interruption, which, in my opinion, may have lot more to offer. Given the social, economic and political forces that constantly assault today’s practicing physicians, it may be the only personal control strategy left. If that’s the case, it’s going to be damn hard for any health IT to change that behavior.