When Esther Dyson asked me to participate in a panel at the Louisville Innovation Summit called “Real-world Care Technologies for Medicaid/Medicare Recipients That Institutions Actually Deploy” next week, I could hear the frustration in her voice in the name of the panel. “Make something useful that people will actually use.”
I stumbled on the word “technology.” What if we said, “real-world care solutions for Medicaid/Medicare recipients that institutions actually deploy.” Is there a difference? Yes. A solution solves a problem. How we solve a problem shouldn’t be the focus.
I think our customers would say, “if you have to do it with technology, fine.” They are not excited about technology. Who can blame them? In health care, technology has created real-world unhappiness, implementation complexity, low morale and a poor user experience for patients and care providers. To our buyer, technology invokes extra steps on the way to getting the problem solved: IT implementation backlogs, security review, and anxiety about data stewardship.
It would be best if the solution was apparent and the technology disappeared.
Which reminds me of this story:
The architect hired to re-design a famous museum pitched his designs to the Board of Trustees as follows: He said, “If you give me enough money, I’ll design you a beautiful building. If you give me more, I’ll make it disappear.” What a seduction!
Can technology ever be so good it disappears? Yes! Here’s an example: my husband and I were on a long drive recently on an unfamiliar road. I was driving and we were deeply engrossed in a conversation. The kids were asleep in the back of the car. For a moment, in our busy lives, it felt like we had all the time in the world, just to talk.
I had forgotten the one earphone in my left ear. At the right moment, Google maps told me to turn right, and I did so effortlessly, without even a pause in the conversation, as if we were driving a route we had driven hundreds of times. The conversation stayed in the foreground, the technology disappeared where it belonged.
Health care technology needs to disappear. Instead, it’s ugly, heavy infrastructure is everywhere. EHRs interfere with conversations, portals and call centers do not recognize us the way our consumer technology does, fancy algorithms serve only to generate paper lists. We are, perhaps, at the peak of ugly, cumbersome, awful technology. It can only get better from here.
We urgently need conversations that are not interrupted by technology. Better conversations are key to higher quality, lower cost care and better patient experience. Motivational interviewing, advanced care planning, shared decisionmaking and good old thoughtful recommendations all require time-consuming and often intimate conversations that can make both patient and provider feel quite vulnerable. These conversations can never be replaced, but they can be supported by…technology, especially the disappearing, consumer-friendly kind.
Patients and providers are so desperate to relate as humans again. We don’t need to throw out the technology, it just needs to disappear. Soon.
Hilary Hatch is the Founder and CEO of VitalScore.
The paradigm paralysis of our nation’s healthcare has a death-hold on our healthcare industry. Just look at the last post from “It Does Not Add Up” by Jack Heidl. I surmise that a widely acknowledged and supported set of fundamental definitions will be required. It is likely that widely divergent views already exist for such an effort . I propose my own list for: HEALTH, CARING RELATIONSHIP, SOCIAL CAPITAL, COMMON GOOD and INSTITUTION. A possible definition for these five terms can be found on the home Page of: http://www.nationalhealthusa.net I particularly like the definition of an Institution, as proposed by Nobel Prize Winner, Elinor Ostrom (especially its last two words).
I spent nearly 40 years during my Primary Care practice using a hospital order form that was coupled with real time sequential physician notes. You could easily determine who was directing various elements and timing of the person’s hospital care. Nothing in the care plan of any EMR for a hospital in Omaha can tell you who ordered what or when. The need to dig deeper is prevented by the loss of time efficiency to figure it out. The mental energy invested in this scenario precludes any meaningful investment in a connection with the patient. Given the huge investment in these EMR to date, I am not optimistic. I vote to terminate the “meaningful use” federal initiative.
Amen to this! Technology should be in the background. Not between the physician and the patient.
3. Any sufficiently advanced technology is indistinguishable from magic.