How to Translate Value in 21st -Century Healthcare

Never trust the translation or interpretation of something without first trusting its interpreter.

The first translations come from within. Translations of chemicals reactions into emotional ones.  Translations of thought into speech. Translations of intent into action.  Our awareness of these translations evolves as we age, as we gain trust in our own internal interpretations and their impact on the world we live in. 

Across the globe, the healthcare industry has been in the midst of a vast translation project itself, creating the industry’s own Rosetta stone to translate the clinical and the code, so that they can converse and collaborate. As the amount of electronic data documenting, analyzing, and actualizing our health and wellness increases exponentially, care providers and health IT solutions developers across the earth toil tirelessly to build trust between their tribes, between clinical and IT cultures, as they translate health information technologies functions into tools and tasks that aid the clinical workflow. Like modern-day Marco Polos, these individuals together write new Marvels of the World for us all to read, writing narratives for us to describe our body’s internal landscapes and maps for us to navigate the unpredictable turns across our own lands and seas.    

Translating Value between Cultures

Translation is a journey over a sea from one shore to the other. Sometimes I think of myself as a smuggler: I cross the frontier of language with my booty of words, ideas, images, and metaphors.

Since she was five years old, the language and culture of caring that clinicians operate in when they begin to practice medicine fascinated Rachelle Blake.  Entering that culture herself as a physician assistant in the 1980s, Blake relished all the joys and sorrows that attend delivering health at the point of care.

Like the early pioneers who saw the frontier and headed west, Blake observed the impact that information technology was going to have on the delivery of healthcare.  As a result, she moved from a familiar culture to a new and fast-evolving one, writing translations along the way between the languages of delivering care and delivering code.  Blake, a recent recipient of the 2016 Most Influential Women in HIT award, has continued to translate the clinical and the code all over the world.  And those “translation” experiences across continents and industries support  Blake and the many stakeholders she works with, as she coordinates the EU*US eHealth Workforce Development Project. The European Commission funds this Horizon 2020 program to “map skills and competencies; provide access to knowledge, tools and platforms; and strengthen, disseminate and exploit success outcomes for a skilled transatlantic eHealth workforce.”

Translating Value through Collaboration

Translation is a kind of transubstantiation… You choose your philosophy of translation just as you choose how to live: the free adaptation that sacrifices detail to meaning, the strict crib that sacrifices meaning to exactitude. The poet moves from life to language, the translator moves from language to life; both like the immigrant, try to identify the invisible, what's between the lines, the mysterious implications.

Blake’s 30 years of leading teams through the development, implementation, and optimization of health IT has given her many opportunities to practice the art of translation and the value that health IT can bring to care delivery.

Asked during a recent interview for HIMSS’s STEPS to Value podcast to name the primary indicator of success in a health IT project, her answer was simple, yet not necessarily an easy one.

“Integrate clinicians from day one,” Blake shared with STEPS to Value host Rod Piechowski, as they talked the day after she received her award at HIMSS17.  Blake and Piechowski discussed the importance for developers to observe the impact their technologies have on a clinician’s workflow and to engage clinicians in an iterative process to design the optimal care delivery experience, one that brings joy back to both the clinician and patient in the delivery and consumption of healthcare services. 

Blake went on to urge clinicians to think more holistically about their own interactions with the IT staff that are increasingly part of their care-delivery experience in the 21st century.  “Don’t be insulted when they ask you first if the system is on,” Blake said, as described the importance of IT professionals’ own list of vital signs that they check when first diagnosing an issue with a piece of technology.    

Translating Care in the 21st Century

Every act of communication is a miracle of translation.

As new digital networks ensnare the world and enmesh us closer together, the need for translation is more important now than at any other time in human history.  The world cries out for interpreters in all cultures to help explain ourselves to us and each other, to allow us to come together to write universal stories that speak to the core of people in every longitude and latitude. 

Stories that bring us closer to each another and our collective spirit. Stories that remind us that the stars over our heads tonight will be over other’s heads tomorrow.   Stories that answer the simple, not necessarily easy, questions that are at the heart of delivering care in any form, no matter what the tools used to enable it, “What’s wrong?” and “How can I help?”