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No problem answering other questions as well!

Doctors seem to be too busy to learn anything that isn't directly related to what they do. And I mean absolutely directly related to exactly what they went to school for. For example, a doctor I know wanted to learn how to use the dictation software, Dragon Naturally Speaking, but literally said he wasn't willing to spend a weekend learning how to use the software, and this is one of the younger dudes who actually isn't that terrible with computers. So instead, he speaks into an old Sony dictaphone where they have to pay someone to transcribe his notes (which has now been outsourced as they killed their transcription department).

Some more examples: Docs get company e-mail address, still use @hotmail account, then sends transcriptions to a company email address using that account, when he could just use his company e-mail and be within HIPAA rules Docs ask to be able to do video conferencing, never use it, never ask about it Docs want new PACS system, aren't willing to take time to look through different options Docs don't want to provide IT with an office or sufficient server storage space because it doesn't 'make any money'

Really, a lot of them are so far up their own ass they don't think they should do anything that isn't something only a doctor does. They don't like writing down their own notes if they don't have to, they don't want to pull up their patients charts on the computer if they don't have to, they won't pull up patient images if they don't have to, they won't pull up and access hospital websites if they don't have to.

Another thing, they'll ask us to help them out right now, then be too busy to do anything "but here's my computer, take a look". Well, it's a website issue for which I don't have an account, soooo....

Docs can technically stay on paper charts, but they lose out on a lot of financial incentives. I can see their beef with this, but it comes down to money and the future. There really needs to be an EMR that can be fully tablet effective, to just be like a digital paper chart in many ways, this would help them a lot. But onetime we provided docs with Dell XT3 touch screen tablets, and we got told it was 1990's technology. It was one of the most ignorant things I'd ever heard. This i7, 16gb, solid state drive, touchscreen LAPTOP, is 90's technology? OK.

Really, they just don't want to take the time to learn things, some things do get in the way compared to the past, but when people embrace the changes it becomes pretty normal for them

I feel the same way as you in a lot of ways, I don't care if people know I saw the dentist and got a cavity filled, or that my last physical was good. For a lot of people though, medical records can be a source of embarrassment. For example, those with STDs aren't going to want that info made public.

What may be even more relevant though, is that within all this information that's part of medical records are things like SSN, date of birth, insurance information, driver's license info. Identities can be stole with that information really easily. Why this is more stressed when it comes to healthcare than say your banks or other places that use this info, I'm not positive of. Another part of it though is that if some of this information is made publicly available in someway I could see employers abusing this information and turning down people for jobs, or firing people.

Often medical records have pictures too, I have a plastic surgeon client and I'll be damned if I wasn't surprised the first time I saw a before and after pictures of a client who got breast implants sitting on a shelf. They did a good job...

I don't want to start a debate of any type, but I would like to ask if you have volunteered to be on this committees? Because that's often an issue, doctor's won't invest the time to research these systems on their own so they rely on people who aren't in their shoes to do it for them, for whatever reason, then they later complain about what was selected even though they didn't want to take the time to look into it themselves. I once had a group of doctor's approve the purchase of about 40 touch screen laptops 2-3 years ago, to later come back and say they hated it and they never approved it when they were literally given a demo of the product and approved it and liked it, to later say they hated it and put the blame on someone else. We even offered the demo laptop to use in clinical settings and they just decided to ignore it, then later say they hated it. It's frustrating, doctors want what they want but they're not willing to put some time into researching it.

I am not the type of IT person who just sits behind a desk in an IT department, I am very often out and about with the doctors and their nurses near exam rooms and see a lot of what they do and understand time is important and understand the work flow very well, as I'm often helping them with things they want setup for their job. I've seen the check-in process, taking patients to their rooms, viewing patient images, viewing patient charts, dictating patient notes, and then the patient checks-out. I understand what time means and I need to understand what you guys do daily in order to do my job to my best ability, in my opinion. I've also seen the back-end doctors don't see, such as billing processes, what transcriptionists do, what their surgery schedulers do, what their x-ray and mri department does, what their receptionists do. I'm all around the clinic and have to help every person in every job role. I've also been around surgery centers with their receptionists, with their schedulers, their nurses, working on computers during surgeries, I'm not a doctor, but I know a lot of what is required for them to work. I know how bad it is when 3 patients show up 5 minutes late each and what that does to a work schedule. I know they're on call and need access to view patient images from home to avoid having to drive to the hospital just to look at a picture to decide whether or not they need to go in. I know without this technology you'd spend countless hours driving to the hospital when you didn't need to. I really do have a wide reaching picture for what you do.

It's honestly about ROI. If you spend time now, you will save time in the future, just take a moment to learn something and contribute your thoughts on a system and you can save yourself the headache later. You can only pay people to make decisions for you to a point.

Anthroplogy is often intention neutral but your research seems to have a 'cause' behind it that is more than just providing education for others to make their on decisions. What made you decide to take this approach?

Most importantly, you can learn what is entailed in HIPAA. In it's most basic form, any violation is when your patient data is put at preventable risk. So while you're at the clinic, to see how trustworthy your company is, basically look for ways you could violate another patients information (without actually doing it of course). I had a client that would leave the patient in the exam room with the exam room computer logged in and the patient images pulled up on the screen, while no one else was in the room with the patient. At this point, as the patient, you would be able to get on that computer, hit the back button, and start searching through the site looking for other patients, all without being asked for a password because they left it logged in. If you can read patient information because it's left on the counter in an easy to read place, there's a sign, if you could swipe a chart off a counter, there's a sign, if you can walk to the bathroom and there's no one around to stop you from doing this, there's another sign. Places where you can read off their monitors easily is yet another sign.

TL;DR if you find that you can exploit other patients info while you're at the doctor, other people can do the same to you.

You may also try testing them over the phone to see if they would give out any info without you having to prove it's you, then question them about it. I'm not saying harass your clinic, but that's how you can see on the front end. And generally, my guess would be if there not doing these simple things (locking computers, having monitor screens where necessary) then they probably also aren't doing the other more articulate IT stuff either. Mostly due to costs, whether it's software/hardware/or labor. These small clinics can't afford a full time IT person, so when they contract out it's hourly, and it's not cheap.

To answer the second part of your question! I personally do not have any certs, I was lucky and was able to break into the field with a relatively small company looking to train people their way. Most of my training was self taught, as necessary on the job. My luck being I'm very good at figuring things out and able to pick up on learning new things in order to learn new things. The internet is a great resource while you're working on an issue, most issues someone has had before you, and hopefully everything else is covered by the vendor ;)

I personally don't have any certs, most companies will like seeing basic ones like A+ or Network+, as it's the equiv of a high school diploma, it shows you did some work to try to get your foot in the door. My company offered to pay for certs a while back but I'm actually finding myself in a position where I know more than enough for my current job, but I'm lacking certain qualifications to move elsewhere, not that I can't learn them though. Once you build a good troubleshooting foundation, and get to test out deploying new technology, all the rest starts to come a whole lot quicker, hope that's helpful!