Given my focus on mitigating Information Overload, I often discuss it with people I meet in other contexts; many interesting insights usually result. Especially interesting are discussions with those people who are responsible for executing literally life-saving jobs under extreme pressure: medical practitioners.
I was visiting a family doctor and raised the subject.
This doctor had a computer on her desk, where she was required by the HMO she works for to type in details of everything she did, from patients’ complaints to diagnoses to prescriptions. What’s more, this was a progressive HMO and it allowed patients to communicate with the doctor electronically by various channels, and to set up their own visit appointments on her calendar through the web. Unlike the early days of computerization, by now most doctors have pretty much mastered typing, so I was expecting she’d view all this electronic wizardry as mostly beneficial.
I was in for a surprise.
What the doctor said
Here is what she said, and it can give you much food for thought even if you aren’t a physician:
- The computer harms her ability to organize her thinking. This I could see myself: she was so busy doing data entry and navigating endless menus, that she was unable to focus her attention on the patient like an old fashioned doctor from bygone days.
- Allowing patients to set appointments online is bad. This was unexpected: why would she prefer to handle it herself? Here’s why: the web interface splits the workday into ten-minute slots, and patients can grab any vacant one. However, not all patients require ten minutes – some need more, others less. It used to be, she explained, that the doctor (or the assisting nurse) would know what each patient would require, and so when one called for an appointment they’d set each up with a suitable duration; what’s more, they’d intentionally put those with expected drawn-out visits at the end of the day, so others wouldn’t be stuck waiting. Such optimization still requires a human scheduler, and this is no longer allowed.
- Patients’ direct access is not as great as you’d think. The patients can IM her, but the time this takes comes on top of a full day’s work. This improved patient service comes at the expense of the doctor’s Work/Life balance (you can bet the HMO didn’t hire extra staff to back the added responsiveness).
- The virtual interaction erodes trust relationships. Patients are offended if she fails to respond in real time to their online communications – which she is bound to do, given her medical duties – and because “It’s all virtual”, she can’t explain the reason to them.
What’s going on here?
All this is yet another instance of technology being introduced without proper attention to the behavioral, psychological and cultural implications. It happens in companies – we’re still grappling with the information overload and distractions brought by email and mobile devices – and it happens in medical practice.
What’s needed, of course, is to slow down a bit on delivering technology and put in a proper process of evaluating the “soft” ramifications. Some organizations do it: Intel Israel (and later Intel worldwide) had the foresight to allow me to set up shop as “Computing Productivity manager”, a role in which I addressed precisely those concerns.
Unfortunately many organizations don’t have the wisdom or the patience to do this, with results such as I describe here. The outcome is overwhelmed workers, unhappy customers, and lower productivity leading to lower business results.
Be well!
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