Viewpoint: The Changing Face of Biomedical Communications

Manuel Bekier, M.S.

A robot glided into our classroom and introduced itself. The robot’s head, an LCD screen, rotated on its neck in my direction, revealing the face of the man talking to me. We made eye contact, and although initially disconcerting, we carried on a conversation. He was a neurologist from California, and at that very moment, was sitting in his office in Santa Barbara, Calif. We later took a short walk together down the hall so I could introduce him and shock one of our administrators. A short while later the robot was able to assume an entirely different identity. This time it was a physician in another part of the country. It was a vivid demonstration of virtual presence. What’s next?

Wow! Things have changed! We are living in an age of instantaneous, “on demand” information where time and distance do not seem to exist anymore. Information is available when and where the user needs it. We also are witnessing technology’s enormous and dramatic impact on the health care industry. More of our hospitals are being transformed into high-tech centers, as health systems try to harness information technology to improve the quality of care. A recent article in U.S. News & World Report, August 1, 2005, revealed highlights from the 2005 Most Wired Hospitals survey, conducted by Hospitals & Health Networks, a publication of the American Hospital Association. This report revealed the growing trend of health centers attempting to develop the most comprehensive information technology network.

The face of biomedical communications has likewise undergone dramatic changes. I entered the field in 1968, well before the “digital age.” Upon graduation from the Medical College of Georgia, with a graduate degree in medical illustration, I headed the medical illustration unit at Mt. Sinai Medical Center in New York. This was the age of film photography, analog television, board-based illustration, and mechanicals. Charts and graphs were done with “Leroy Lettering.” Posters were produced with photo-imaging of type fonts, press-on type, and later with dye-cut vinyl lettering. The most complicated technology I mastered was the Paasche AB airbrush.

The tools have since changed. As we evolved into the digital age, we likewise evolved in the way we did business and the services we offered. Our field also had become far more complex. Biomedical communications, an “umbrella” term, encompassed many different professional specialties. Some of us worked alone and some of us worked together in a commercial or academic setting, with great variance in administrative structure and budget.

Information technology, coupled with the economic situation, has dramatically changed the traditional ways we have managed our departments. In the past decade, we have noticed that few units have grown larger and most appear to be struggling for survival. The role of many department directors has shifted from an education and communications professional to that of a manager of a cost-recovery service department. This, in turn, resulted in a change from the proactive to the reactive. Rather than focusing on the most effective means of communication, the focus became one of managing resources and bottom lines. In the early 1990s, quite a number of biomedical communication units became incorporated into the medical libraries and departments of medical education. The term “Medical Informatics” was introduced. This term represented a blend of biomedical communications, computer technology, and library technology. This was how we envisioned our future.

Prompted by increasingly severe economic constraints in the health care industry over the past decade, we have seen biomedical communication units split up. Upon retirement of its director, the services once performed by a biomedical communications unit were often taken over by the campus information technology department or public relations department.

Reba Benschoter, Ph.D., a past president of both ABCD and HeSCA, has expressed on a number of occasions the growing concern about the future of our discipline. She has written a number of insightful articles in JBC addressing our survival as a discipline (Can the Biomedical Communications Unit Survive? JBC Vol. 21, No.1, 1994), and Where is our Future? (JBC Vol. 27, No.1, 2000). Based on a 1993 survey of the membership and on her personal communications with members of ABCD, Dr. Benschoter cited the growing concern with the rapidly changing technology and the decreasing need for biomedical communications services. Computers, video equipment, and cameras have become much simpler to operate, as well as less expensive. As a result, many of our clientele are turning to cheaper, “non-professional” alternatives or to production of their own media. A significant number of our membership felt that biomedical communications, as a discreet field, was at a “crossroads” and could very well be absorbed by an information technology service.

I believe our most important issue today is to redefine and reposition ourselves in the expanding field of information technology. Many professional groups are laying claim to information technology, which is, as Tom Singarella, Ph.D., (also a past president of both ABCD and HeSCA) aptly stated, “a widely encompassing term which means different things to different professional groups” (JBC Vol. 26, No. 2, 1999). Dr. Singarella illustrated this with the analogy of the seven blind men who touch different parts of an elephant, thereby gaining their own varied and limited perceptions of what the animal actually is.

So what is it? It is IT (Information Technology), and we (departments of biomedical communications) are an integral part of IT? I am not prepared today to eulogize biomedical communications. Rather, we must position ourselves to become a vital component at our health centers in the delivery of IT.

We are, like so many other professionals, in the information technology services. So what distinguishes us from all the others in IT on our campus? How should we position ourselves? IT is not the sole domain of the computer center or any one group.

There are many organizations and groups that have been formed that are heavily focused on information management and technology in the health sciences. It is not entirely clear as to who is doing what, and to what degree they are engaged in overlapping activities. Many of these groups are attempting to position themselves to gain control by becoming the information “gatekeeper.” At most institutions this is the chief information officer (CIO), followed by the director of the medical library.

It is obvious that different IT groups have their own area of focus and expertise, and they should be coordinated in order to meet specific objectives. However, this coordination can be achieved without all of the groups giving up their autonomy if organized by being administratively under the control of a single department. Our CIO has been highly effective in bringing together and coordinating the efforts of various groups (not all under his administrative aegis) in working towards accomplishing a particular objective.

We must bear in mind that as we evolve the tools will be constantly changing, but good communication skills and good design will always remain a constant. Anyone can learn to use the tools (software developers are making them more user-friendly every day). However, a combination of skills and experience acquired over many years is required to properly use these tools effectively.

When I interview potential employees, I let them know that their tools will change and they are expected to learn how to use them. Consequently, I attempt to identify individuals who show the desire to take the initiative to learn and to master new software, as well as demonstrate a willingness to share their expertise with fellow staff members. By way of example, when the Web first made its public appearance, I had my department create a “mock” center Web page for our senior administration. Our graphic designers were suddenly required to work with and master Web pages. This exercise eventually led to an extension of my department’s responsibilities—oversight of our institutional Website (graphic appearance, navigational architecture, Web database development, as well as maintenance of the Web servers).

What should our role be?

There is an overwhelming amount of impressive technology that is being marketed for education and the health sciences that actually does very little to increase communication effectiveness. I believe it is our role to identify and match the technology with the communication objective.

Whether the services we deliver are under IT, another division, or autonomous within biomedical communications will vary with each institution and administration politics. To what degree biocommunication directors can influence organizational structure will vary greatly among those directors and their respective institutions. Nevertheless, it is vital that we become more proactive and let everyone on our various campuses know that we have the unique set of skills required to effectively use technology in support of the institutional mission. Our professional experience and education provides us with the ability to understand the communication objectives of our faculty and to bring together the most appropriate technology to meet those needs. To succeed in this endeavor, we must seek advocates in the administration, as well as among the faculty, and we must develop strategic relationships with others who play a role in information services. We need to partner with our IT, medical library, and other groups on campus and be invited to strategic planning meetings. As Dr. Singarella said, “The computer technologists may know the technology and understand the intricacies of how it all works, but we can help shape or refine the technology to serve specific needs of the faculty.” We are the people who best understand the communication needs of our faculty and who can best help determine what is the most appropriate technology, or combination of technologies, and how to best implement them to meet specific communication objectives.

Can we retain the autonomy of our biomedical communication units? I believe we can; however, in addition to staying current with information technology, we need to be able to provide unique services that clearly support the mission of our centers.

We must be proactive and try to be a dynamic force on our campuses, which means we must be responsive and anticipate the needs of our faculty. As we work on determining and responding to needs, we also must develop a loyal client base. In addition, we must find ways to fund new technology, as well as find and retain qualified staff. This is nothing new to my colleagues in the field of biomedical communications. They have been citing these problems for years. The real trick is determining how to go about solving them.

Editor’s note: If you have thoughts on how to address these questions, please submit your Viewpoint to the JBC.

About the Author
Manuel Bekier, M.S., is the director of Biomedical Communications at State University of New York at Downstate Medical Center, and is the current president of the Association of Biomedical Communication Directors (ABCD), as well as a member of The Health and Science Communications Association (HeSCA). Manuel Bekier is a graduate of the Medical College of Georgia School of Medical Illustration. E-mail: Manny.Bekier@downstate.edu