In the realm of healthcare – come back when you’re perfect

Written by on January 29, 2016 in Guest Blog with 0 Comments

Doctor using digital tabletConsumers don’t demand perfection so much as they thirst for novelty. Apple’s whole business model, for example, seems to be built on satisfying that thirst with endless tweaks and iterations of non-essential goodies: smartphones abound, but iPhones are still part luxury, part status symbol, part obligatory purchase for fans loyal to the brand.

Enterprise solutions, meanwhile, are nearly the opposite. Something that works is more valuable than something that stimulates and delights. The scale and cost involved in acquiring new enterprise technology precludes, say, Macs as a viable option compared to PCs.

Hence the challenge in moving something popular among consumers to a larger level of commercial adoption: early adoption is an individual consumer trend more than a corporate function. The common attitude toward emerging technology at the enterprise level is one of skepticism. If something isn’t perfect yet, it isn’t worth adopting.

Consumer demand helps drive corporate behavior into adopting and adapting to new technology, once expectations have shifted to accommodate the disruptive new thing. It may not be perfect, but it sets a new baseline for speed, accuracy, service – whatever.

But at other times the marketplace is insulated from that demand, and thus free to stagnate even as the rest of the world is thoroughly disrupted.

This is the current state of communications technology in America’s medical sector.

As every other corner of the market shifted to keep up with the pace of change and flow of information in the digital age, hospitals and healthcare centers remained comfortably analog. Consumer demand, insulated by the various levels of bureaucracy, insurance networks, and the basic fact that everyone needs healthcare at one point or other, made it easier for American medicine to carry on without jumping aboard any new disruptive trend.

Then, over the course of several years, the federal laws tried to substitute for natural consumer forces and compel healthcare providers to abandon paper records, faxing machines, and hand-written notes in favor of digital systems and Electronic Health Records (EHRs) that could follow patients anywhere without delay or duplication. The potential value of digitizing healthcare information management seems intuitive, yet its field test has proven less so.

The whole hapless forcing function that was the Meaningful Use program reads as something of a cautionary tale: developers created solutions according to federal standards, rather than user (clinician) needs and demands. Adoption was compulsory, rather than organic. Resistance and frustration was common, while workflows remained rooted in analog processes, and seasoned physicians opted to retire early rather than put up with this mandated disruption.

In short, clinicians were forced to adopt imperfect solutions, and rebelled because the solutions were imperfect. Developers, meanwhile, asserted that clinicians were being stubborn and unwilling to accommodate their new solutions. Care didn’t improve, and in many ways neither did the technology.

At this point, Meaningful Use is being retired, the intended replacement designed not to force adoption of new tech, but to judge outcomes utilizing new tech. In theory, this brings healthcare’s model of change and adaptation more closely in line with other industries: better serve your consumers, or face the consequences.

This doesn’t change the basic need for better communication between users and developers—the absence of which has plagued both throughout the shift to digital.

Accommodating existing workflows is impossible when users aren’t involved in development. Likewise, workflows that historically put every user (every clinic, every specialists, every network and patient record) in a silo must change to embrace, troubleshoot, and advance the exchange and utilization of EHRs.

Even after the painful experience of the last few years, however, there is still a powerful cohort of users demanding that, before they be expected to use the technology, the technology be perfected.

Perfection cannot—and does not—ever predate utilization. Clunky personal computers give way to sexy, compact tablets because users multiply and generate a stream of feedback. Even in the “special case” realm of healthcare, with its forced development and compulsory integration, things cannot get better until the users and developers see themselves as on the same team.

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About the Author

About the Author: Edgar Wilson is an Oregon native writing on trends in health, education, and global affairs. He studied conflict resolution and international relations and has worked in industries ranging from international marketing to broadcast journalism. He is currently working as an independent analytical consultant. He can be reached on Twitter (@EdgarTwilson), and more of his work viewed at .


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