

Like most others, I took English in elementary school. It wasn’t that hard, after all I had been practicing for quite a while. In high school, I tried a little French. Not as easy, but I got through it. In social work school, they were ready to teach me a new language as well. It was my chosen field so there was no argument there. Even in grad school as the terms got more difficult, the diagnoses more complex, things were still ok. Then at some point it was decided that social workers should be techno savvy as well. And so, for the seasoned vet, those comfortable in the practices and procedures, the virtual nightmare began.
It started off simply. They gave us computers. Had us work in Microsoft word. A mouse wasn’t particularly scary and cut and paste took on new meaning. If you had to hunt and peck, no one seemed to care. Documentation was still the same, long empty pages with lines that served as progress notes, assessments that were merely outlines where you could write as much as you wanted. But then maybe fifteen years ago or so, the virtual writing on the wall became clear (by email none the less). Electronic record keeping was the wave of the future….. “…..to make us more efficient, to spend more time with clients and less on paperwork, to make our lives easier.”
Hence, TSL began, Technology as a second language. The journey has not been easy for everyone. Those younger folks who were already “computer savvy” didn’t find it as difficult. And that has become even more apparent with each coming year. The younger generation doesn’t care that you have 20 passwords and they change every other day. They write in short concise sentences. They don’t seem to care that the “username” isn’t always the name people call you. They are comfortable with tabs, check boxes, alerts, and multiple screens minimized on the bottom. In fact, they even seem to like them.
But then there are the “dinosaurs.” Those who yearn for a pen and paper and written memos. They lament when someone tells them that the “information” is online. They cringe when the memo (well email) comes out asking people not to print anything because it’s all available in a file or a folder or by way of a link. They cry silently in their offices when it takes an hour to find something that used to be in a pile on their desks or when they complete a report and then somehow can’t figure out where it was saved (or if it was saved).
Therapists understand that “change is hard,” and they are sensitive to their clients who have to slowly work through change. They encourage their clients to normalize their feelings, realize they are strong and they can manage changes. And yet, they don’t always want to embrace change so much when it comes to technology and the computer.
Technology as a second language is actually great. If only those who speak it can be sensitive to those who don’t. The electronic record does in fact do everything it says it will. It can organize and save and help us find what we need quickly and efficiently. The record helps us keep straight what needs to be done and when without our own little charts and graphs on yellow tablets. We don’t have to keep a little calendar of who we saw, for how long, and who participated. It’s all there, in a note, a report, a graph and more.
But it is a different language. Those who teach it need to remember that. We don’t roll our eyes at the family who doesn’t speak English when we try to help them find the bathroom. So why would we do so for the therapist who asks for the fifth time, “how do I find the file.”
When we are teaching someone a new language, we are patient. We talk slowly, we repeat ourselves, we ask someone to repeat back to us to make sure they got it. We understand. We can’t grab the mouse, say “you just click here, and then here, move over here, go to this drive, type, insert, copy, paste, save, insert and close…..” We can’t say, “there, it’s just that simple.” Have a nice day.
And those of us that are the “learners,” need to be willing and open. We need to be honest when we don’t understand. We need to be willing to practice, to try, to be ok with failure and accept the learning curve. We need to become the communicators as much as the listeners.
Electronic records are our reality. Even if there wasn’t a course on it in graduate school. Managed care needs integration, Health homes need more integration, and no one can argue about the need to be more efficient. Electronic records are not the enemy; they are the help we never knew we needed. No one has said you either can be sensitive to your clients or you can be a computer expert. You can be both. But neither can we say “you’re on your own.”
I have experienced many sincere attempts at partnerships between IT people and clinicians over the years. The good ones on both sides have grown to understand that a common language is critical and a challenge. And they have found ways to make that happen. It’s worked for the mutual benefit of both. The clinicians have learned not to be afraid of the keyboard and the mouse while the technicians have come to understand the challenges and good work that is being done by providers.
And thus, you can teach an old dog new tricks. Maybe next I’ll start to learn Italian………

