Mary (Missy) Cummings, Professor at MIT’s Humans and Automation Laboratory and a former fighter pilot who “loved dropping bombs and loved striking targets – 3000 rounds per minute you can’t beat that” has shared some creative ideas about how healthcare industry roles can be redefined through the automation of rule based behaviours.
“If you can do what I do as well as I can what does that make me?”
At a stretch I can just about imagine some of the stresses of being a fighter pilot but being able to do that job whilst putting up with a work environment where inebriated colleagues shared attitudes like that… WOW.
It’s also another fascinating insight into the frailty of the human ego. I sometimes hear a similar sentiment being shared by Doctors when I’m demoing the patient history taking tool we use as part of the consultation process here at 3G Doctor.
Despite the clinical validation this questionnaire technology has already got (check out this paper by Dr John Bachman MD, Prof of Primary Care at the Mayo Clinic) many Doctors choose to ignore the opportunity it presents to complement their ability to care by immortalising the world’s best history taking skills and removing the time/cost/effort associated with them documenting this information themselves instead many just consider it’s existence as though it is a challenge to their very existence.
“We have somehow stilled the skill set of a pilot – which in the past took many years of training and more than a million dollars – into an iPhone…. …and you would not believe the hate email I got from military and commercial pilots who were very resentful that I was somehow trivializing their task”
This video’s going to help you understand the level of simplification of what this Professor has achieved here:
Of course being able to move around an iPhone doesn’t make you much of a pilot but it’s an incredible example of the simplification processes that the mobile phone is going to bring to the healthcare industry in the next few years eg. if you can reduce the complexity of flying pretty much down to waving of your arms can you imagine what you could do to a Doctors view of a patients record and the opportunity to phase out so many of those unwieldy labor intensive interactions that impact on the effectiveness of healthcare workers and administrative staff?
“It’s not about replacement it’s about redefining the role… …We’re able to automate rule based behaviours every day more and more… …but there will always be knowledge based behaviour that is required when humans are faced with lots of uncertainty where you have to rely on your judgement and experience, there are things out there that can’t be figured out with an algorithm so we’ve got to make a best guess – this is the domain where human beings really do reign supreme, we are excellent, far better at automation and will be for a long time at making best guesses given a lots of uncertainty in the world”
I think it’s really important that mHealth developers understand this point. I’ve wrote at length about the confusion you get when you start thinking health decisions can be made by Algorithms alone but it’s critical that we use tech not to replace people but to redefine their roles.
The only challenge I have to this talk would be that there might be an assumption being made that at the moment Doctors are in general listening to everything the patient can tell them and are using recognised and documented work flows and up to date subject manuals.
Obviously we’ve started building this at 3G Doctor but in the vast majority of primary care encounters we’re nowhere near the stage where we can benefit from flight data recorder analysis (because there is no documentation) but rather we’re at a similar stage to where the aviation industry was in back in 1930 before the Boeing B17 taught the aviation world of the importance of good documentation and checklists: