When Technology Isn’t the Answer

Technology is supposed to improve outcomes and efficiency especially when it comes to “health-information technology” (HIT). But it’s not always that simple. Zachary Meisel, a doctor/writer, argues that two recent studies of HIT in Pittsburgh and Philadelphia revealed some complications. “In Pittsburgh, medications were given too frequently because the computer used standardized dosing times to order medication (as opposed to using the time of the first dose to calculate time to the next dose),” Meisel writes. “In the Philadelphia study, many of the problems arose from what are known as human-machine interface flaws. For example, doctors would sometimes assume that a display of?standard doses were?suggested doses specific to the patient being treated at that moment (not the same thing!).” Meisel also worries about the loss of communication between doctors and others (radiologists for example), as such communication often leads to better patient care. [%comments]

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  1. Drill-Baby-Drill drill Team says:

    95% of all medication is self administered by the patient or family. And patients miss doses, skip doses, forget doses, mix up their medications, travel and forget to bring their medicines, and try to save money on medicines.

    Technology does not touch this.

    The dosing regimen is only as robust as its weakest link.

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  2. Rosewood says:

    There is a technology problem there in so much as the user interface isn’t well designed if those are the problems they are having. But really that is a human factors issue.

    But there is also a plain human issue — the people aren’t trained.

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  3. Jay says:

    It’s an interesting point and shows the potential growing pains as we try to adapt tech to new applications…but I find the headline a bit misleading. It suggests that tech isn’t the solutions, where really Meisel is saying that badly designed tech isn’t the answer.

    If we look at the examples you mention, you have one where the programming is wrong in the application of dosing times and another where the basic design of the app lead doctors to make a wrong assumption about how it works. These aren’t example of tech not being the answer, but humans not being able to apply the tech in the right way.

    The argument that tech might take away communication is a good one though. No matter what, you can’t replace the value of meeting face-to-face and spending time going over something in person.

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  4. Laura L. Nelson, Ph. D. says:

    This is an example of the technology running our lives rather than our using the technology wisely to improve our lives.

    I would like to meet the people who said that info tech would make our lives easier. I would like to go postal with them, because just as Reddy Kilowatt lied about virtually free energy in the 1960′s, those experts who pushed us into wiring everything from customer service to (un)edited encyclopedias were sadly mistaken.
    Paperless office? Give me a break. ROTFL.
    Bitterly.

    This is all yet one more example of human technological ingenuity outrunning humans’ rational choices. We can. Should we? The question of should vs. shouldn’t is too rarely asked. Many people who are now unemployed are victims of this unthinking adoption of new technologies. Children who spend their time in virtual worlds rather than the real world are victims of this new technology.

    Yes, we have the “information technology.” It does not mean that we do not have to THINK, people, THINK about what we are doing with it and what it is doing with us and to us. Too often, the software runs us rather than us running the software.

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  5. Steve Cades says:

    Anyone who has used a complex piece of software can explain the problem described here: Insufficient attention to users’ reactions; too much design by software developers. No disrespect intended toward developers; just a very different mindset than those of users.
    For hospital applications: Pay closest attention to the reactions of nurses; secondarily to physicians. It’s the people who do the direct patient care, distribute meds, oversee feeding, etc., who will spot the ambiguities and plain problems with the machine-user interface. Every time a new or modified system is introduced, hire a team of anthropologists or psychologists to shadow the nurses and note every grunt and grimace, and then ask “what have we got wrong?”
    At a personal level, I wish I had a dollar for every time I’ve had to interpret a message from a technician, or a modified screen on a revised application, for my highly intelligent, but non-technical wife. I understand the economic drivers of sub-optimal user interfaces, but by now the whole industry should see the advantages of “sweating the details” as Apple, driven by Steve Jobs, does.

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  6. Brett says:

    There’s no such thing as a problem with technology. It’s either a problem with the people designing/manufacturing the technology or a problem with the people using the technology.

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  7. Eric M. Jones says:

    “It’s a poor workman who blames his tools….”

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  8. Ian Kemmish says:

    The “loss of communication” point appears to be based on anecdotal evidence with a sample size of one. The good doctor might at least say how many lives he believes were saved by his informal chats with the radiologists, and whether anybody at all can corroborate this opinion.

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