PATIENTS IN HOSPITALS find themselves surrounded by all manner of advanced equipment. But few of those marvels of technology can “talk” to one another to share vital information. Equipment made by different manufacturers is likely to communicate in its own language, or at least its own dialect. Julian Goldman, an anesthesiologist at MGH, has been on a mission to solve this problem. “Babel in the ICU,” on page 6 of this issue of Proto, shows how better sharing of data between devices might help avert more than a third of the injuries and deaths caused by medical errors.

Partners HealthCare, MGH’s parent organization, is in the midst of solving a related problem in which the software systems supporting different types of electronic health records don’t communicate well—or at all—with one another. A massive new information technology system will create one unified health record for each of the 3.3 million patients in the Partners network. The idea is not only to improve efficiency but also to allow clinicians to analyze patient data and cut down on medical errors—to enable, for example, a physician at one institution to quickly learn about an allergy that had been identified at another.

Digital solutions often come with their own issues—some relatively minor, such as the learning curve for a new system, but others more serious. Some providers of electronic health record technology have taken advantage of hospitals’ reliance on their systems and blocked access to records. The problem, described on page 5, is so severe that Congress considered deeming it a federal crime this year. Meanwhile, as new technology finds its way into the hospital, some workers may worry that they’ll no longer be needed. But in “Calling Nurse Robot,” on page 4, Brian Herriot, who has put dozens of robots to work at UCSF Medical Center, argues that the help that robots and other technologies offer can free employees to take on new responsibilities using skills that robots don’t have.

Amid all of these challenges of rapidly changing technology, it’s important to remember that digital innovation shouldn’t be pursued just for the sake of efficiency and cost-effectiveness—the ultimate goal must always be to provide patients with the best and safest possible care. And achieving that objective often has more to do with people than equipment.

This year at MGH, we implemented a new process we call a “warm hand-off.” When a patient is transferred from MGH to another facility, a complete discharge summary and medication list goes with them to the next clinical team. To make that process even safer, we make sure that someone on the discharging team communicates directly with a clinician at the new facility so that both sides can collaborate. Though email and other technologies are involved, the core of the process is good old-fashioned human-to-human communication.

Peter L. Slavin, M.D.


Massachusetts General Hospital

Thomas J. Lynch Jr., M.D.

CEO and Chairman

Massachusetts General Physicians Organization