“I want to make one last point and that is I’m always curious when I talk to people like you about whether you make the error of assuming that more of the world is amenable to technological fixes than is actually the case. So let me give just this one example with digital health records: so when I talk to friends of mine who are Doctors who use these things (EHRs) they all hate them and it’s not clear that they hate them because they’re bad at design, they hate them conceptually and they hate them conceptually because they say here’s the problem: you’re the Patient, I’m the Doctor. Before the digital health record I’m talking to you, listening to you, emoting, holding your hands, whatever, then like it was 1970 I would talk into a dictaphone, my secretary would transcribe it and that would be it right? Now they say, what you’re doing is you’re on the keyboard and you’re not looking at the Patient and the Patient gets really upset. And what you have done is you have in the cause of efficiency disrupted the very thing that the Patient really wants in the encounter which is a personal connection with the provider. Now is it possible that this is simply an area of deeply important personal interaction that is not amenable to technological disruption”
I think Malcolm is spot on about the principle frustrations generated by the EHRs Doctors are forced to use but I’m a lot more optimistic because I use the technology that is helping Doctors leapfrog the keyboard and jump from the dictaphone to automated documentation of the physician narrative at the point of care to do my work (and write this blog).
I also think the Patient/Carer’s smartphone and clinically validated interactive Patient History Taking Tools are enabling the technological fix to be finally applied to the Patient side of the consultation. The disruptive opportunity for technology in healthcare that Patients and Doctors want lies in getting out of the way and letting Patient’s help.