Learned helplessness: Millennials and electronic medical records

by Keeley Wray on June 21, 2012

Is healthcare IT ready to grow up? (N Kasp/Wikimedia commons)

As I read more about the Millennials, the generation to which I myself belong, I’m starting to see a connection between their attitude toward the world and the problems plaguing healthcare IT, an industry I research for a living.

Millennials (by one definition, people born between 1981 and 2000) tend to perceive greatness as something that is inherent, not acquired. This fallacy comes in part from the coddling we were given as young people. Millennials received trophies just for participating. Thanks to grade inflation in college, we could sleep through classes and still earn a B. We were told we were special: Success came to us simply by showing up.

This type of attitude leads to inevitable discouragement post-college, when Millennials are faced with challenges they haven’t been prepared to handle. Jobs aren’t handed out just because the applicant has a degree, but instead require connections or specialized skills or experience, and once in those jobs, success doesn’t come automatically. When he doesn’t face immediate success, the Millennial assumes that he’s “different” than the successful people, and attributes the failure to an intrinsic, unchangeable quality rather than faulty methods.

Pretty soon this leads to learned helplessness. Rather than apply the daily, frustrating effort required to solve a difficult problem, we tend to leave it to those who were meant for that kind of life.

I see this dynamic in the healthcare information technology (IT) industry, which seems incapable of introducing the latest innovations (say, the ability to conduct a Google-like query of patient data) and interoperability that other industries enjoy. In the New England Journal of Medicine, Ken Mandl, MD, MPH, and Zak Kohane, MD, PhD, of the Informatics Program at Boston Children’s Hospital, recently criticized “legacy” electronic health record vendors – the companies that have been dominant for decades — for promulgating the idea that the healthcare industry is “different” as an excuse for being far behind other industries in introducing technological advancements.

“It is a widely accepted myth that medicine requires complex, highly specialized information-technology systems,” they write. “This myth continues to justify soaring IT costs, burdensome physician workloads, and stagnation in innovation — while doctors become increasingly bound to documentation and communication products that are functionally decades behind those they use in their ‘civilian’ life.”

There seems to be the idea that healthcare IT is too complex, the need for information security too high and doctors too set in their ways to be able to incorporate innovation. The industry seems to be saying, “This is just who we are. Don’t expect anything more.”

Yet other industries are incorporating disruptive approaches. Mandl and Kohane cite the airline and banking industries: they too have sensitive data and “isolated complex systems,” but still manage to share data and incorporate the latest advances in back-end technology infrastructure.

I think Millennials and healthcare IT companies are stuck in a similar rut because they’re missing two keys to success:
•    Experience with hardship or challenge
•    A worthy vision to aspire to.

Compared with their grandparents reared during the Great Depression, Millennials were exposed to little hardship in their youth, and don’t seem to have much of a vision of what they want. The Greatest Generation aspired toward the American Dream — families, property and leadership roles in their businesses. What vision do Millennials have? What compels them to struggle to achieve a difficult goal? If their greatest aspiration is to watch a TV show without interruption… well, then they have already achieved it.

What about the healthcare IT industry? What vision is it aspiring to? What will compel it to initiate the difficult and taxing transition to innovation? Unlike banks and airlines, it doesn’t have to hustle for customers; in fact, I think the industry’s learned helplessness is exacerbated by its relationship to Medicaid and Medicare, guaranteed customers that shelter it from the challenge of free market forces. Medicare and Medicaid have seemed to reward the healthcare industry without asking for anything more than the status quo — just like guilty and overindulgent Boomer parents.

Am I being too hard on Millennials and healthcare IT? Should we just accept poor performance because, well, there is nothing that can be done?

I suggest we employ the Pygmalion effect: start treating both like grown-ups. No more excuses. As Wellesley High School English teacher David McCullough recently told graduating seniors in a commencement address, “you’re not special.”  Hard work is more important then any inherent trait.

Millennials are facing a challenge they never anticipated: an economic downturn. They are going to have to get off the couch, or the TV won’t be there for long. Similarly, as newer systems emerge that allow for cloud-based solutions and interoperability, healthcare IT companies will have to change or become obsolete.

Which do you think will happen sooner: Healthcare IT disrupting itself? Or Millennials growing up?

Besides being a Millennial, Keeley Wray (@Market_Spy) is senior market research analyst in the Technology and Innovation Development Office at Boston Children’s Hospital.

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