I’ve been working with a hospital system client who’s investigating how to create a number of initiatives to work with its various business partners. Chief among those business partners, of course, are doctors–who remain (believe it or not) the most important people in health care. One issue that hospitals are wrestling with now is how to extend their CPOE systems and wireless networks across their facilities, and of course integrate that technology into the business practices of their partner physicians. Of course, most of those physicians who work with the hospitals in this country do not employ them or own them. So that means that the hospitals, who are spending gazillions on information systems, now have to integrate those with physicians’ behavior–in other words with whatever the physicians are bringing in the backdoor.

On example of that behavior is blogging doctor Jacob at Family Medicine Notes. He’s got himself a new Treo 6000. Half the time he’s in the hospital, part of the time he’s in his office. He’s using IM in the hospital, and being paged there. And the Treo cannot yet get on the Wi-Fi, but that’s a matter of months at most. So now you’re a hospital CIO, you have the pressure to get your doctors to use that IT stuff, but then you have the backdoor men bringing their own stuff in. Plus not only do you have to make it all work on multiple platforms, you’ve got HIPAA saying that information must be protected even if its not on your system anymore. A confusing and difficult time for hospital CIOs, but when docs like Jacob are finally pushing the envelope on using technology to improve care and their own care process, an exciting one too, no?