The deterioration of working conditions in the health sector is obvious. Doctors and nurses tell us that they now spend at least half of their time entering data, answering surveys, understanding new software, collecting information on patients… This process is part of the decline of the sector. In France, professionals distribute a leaflet in demonstrations calling for a data strike? This is an inspiration for their Belgian colleagues.
We, professionals of the health, social action and special education sector, call for a strike against management and computerized tools:
- to protect our activities against the rapacity of commercial interests
- to stop the continuous degradation of public services
- to get out of the logic of profitability and control
- to take back control of our businesses
We note a general deterioration in the assistance and care offered to the population, and ever worse working conditions. It’s simple: the health and welfare system and services of general interest are crumbling before our eyes. « At the same time, we all feel that the pressure is increasing, and that this pressure is transmitted through computers.
It’sno coincidence: managers steal our time. Software is proliferating (Cortexte, RIMP, etc. for psychiatry, ISIS, COSMOS, SIAO, etc. for social action), new protocols are emerging, and administrative standards are constantly changing. Inevitably, the time spent on a computer entering data is less time for human relations, meetings and transmissions between colleagues. We can no longer reflect on our work or meet the needs of the people we serve.
It is necessary to « trace » the requests, the acts, the observations, the words, the behaviors, the phone calls… but why and especially for whom? According to the managerial discourse, it would be a matter of « rationalizing the public offer through the implementation of good practices in order to provide a better service to the user », but it is exactly the opposite that is happening! Human beings and the situations they encounter are too complex to fit into standardized boxes.
We work only to respect the procedure, and under threat and blackmail . We have to rate in order not to lose the budget, we have to rate in order to show what we do and supposedly to highlight our work. A double lie: only what is measurable is rated (such maintenance, such activity, however vital, does not « fit » in the software) and all these ratings do not prevent the asphyxiation of public services nor the non-replacement of posts, quite the contrary.
But what happens to the data stored for life in the processing software? In all confidence, or by naivety, people consent to their geolocation, by downloading applications. Digital data is used to define care and support pathways. These are socio-economic data. They are not for the benefit of the patient or the person being assisted, but for the competition of services and professionals. In a context of commoditization of our sectors, they enrich the statistics that are sold to insurance companies and start-ups.
The argument sometimes used is that we have to justify what we are doing to the control authorities in view of the risk of complaints from « users » and their families. In reality, the responsibility for possible errors, omissions and failures is placed on the professionals. We are sold the monitoring and control of our activity for good practices to respect or service organization to improve. The public authorities organize the deterioration of services while pointing the finger at those who keep them going against all odds.
The right to be forgotten and the medical secrecy disappear. What should not come out of the medical record is made available to merchants. Conversely, what should be there (nosography, biography, history of the disease) is lost because the caregiver avoids saying too much in a file that he or she does not know in whose hands it will fall.
IT DOES NOT EXIST
OF GOOD DIGITAL PRACTICE, BECAUSE NEUTRALITY
OF THE COMPUTER TOOL IS A MYTH
We refuse that our jobs are diverted from their meaning, to satisfy a bureaucratic machine at the service of commercial interests.
Enough waste of public money on IT applications and services!
WE CALL FOR A STRIKE OF ALL MANAGEMENT TOOLS
- Within psychiatric facilities
- Social action services and associations
- In all places of reception, assistance and care for the population
How do we go about it?
First: identify the management tools in each of our sectors.
Second: to make them inoperative. Do not attend administrative meetings. Do not fill out diagnoses, procedures, maintenance reports, statistics. Do not fill out the computerized agenda. For example: on Cortexte, do not fill in Edgar (coding of procedures, acts and diagnoses). In Nova and Peps: do not fill in the social file, which implies the computerization of all data (family composition, income, problems and interventions, interview reports).
Third: to support each other and collectively deal with possible threats and retaliatory measures.
Let’s innovate, let’s move to paper and (re)ask ourselves the question, what does this mean in terms of trust and confidentiality? It is up to us, professionals, to create our collection tools. Let’s not leave it to the software companies who sabotage our businesses. Let’s decide collectively what needs to be written down.
The impetus is given by the C. I. H. (Collectif Inter-Hôpitaux), part of the Sauvons l’Hôpital movement, which has called for not coding « T2A » (fee-for-service) procedures.
It is our turn to use this means, the data strike , which, if it is generalized, we are sure will be very effective.
Let’s go ! What are we risking? Everyone has experienced a computer breakdown in his or her department, and the work was done anyway… moreover, the most sensitive departments, such as certain intensive care units, work solely on paper.
Let’s give the strike new weapons. Let’s hit the managers where it hurts: on the data carrier. They won’t survive a server failure, and we won’t die. On the contrary, we will gain more freedom in our work.
Health-Social Action Commission against the management tools of the Printemps de la psychiatrie