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Why Doctors Hate Their Computers (2018)

279 点作者 aarestad超过 4 年前

46 条评论

duffpkg超过 4 年前
I created the open source ClearHealth&#x2F;HealthCloud EMR system, have managed hundreds of medical facilities large and small and am the author of &quot;Hacking Healthcare&quot;. There are a lot of layers to this and competing concerns. This article is misguided at best. The quote &quot;Doctors are among the most technology-avid people in society&quot; is hilariously off the mark. The average age of doctors in the US is 51.<p>Amongst many difficult problems related to this:<p>-Medicare&#x2F;Medicaid&#x2F;Federal spending is half to 2&#x2F;3 of all medical spending. They are insanely bureaucratic and simultaneously penny pinching. They require lots of things that make everyones jobs harder with no obvious benefit to anyone. They dictate in many ways how software must work in medical settings.<p>-Doctors in most institutions are not given an adequate amount of time to accomplish all of the things that need to be accomplished to deliver quality care and also get properly paid for the interaction. This in part is financially driven but I would say it mostly occurs because there is little to no accountability for medical systems to operate well or efficiently. In many situations there are perverse incentives to operate inefficiently.<p>-Doctors make an absolutely shocking amount of substantive errors, 25% of interactions or more. Preventable medical error is almost certainly in the top 5 causes of deaths in the united states.<p>I could go on and on but cherry picking but I think I made my point that this article looks only at one perspective of one facet of disgruntled personnel involved in a single implementation.
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phren0logy超过 4 年前
I&#x27;m an MD, and most medical software is objectively terrible. I&#x27;ve worked in private hospitals, campus student health clinics, jails, juvenile detentions, VAs, group homes, state hospitals (in the US) - and in clinics and hospitals in New Zealand.<p>I have never used an electronic medical record that I would willingly inflict on another person.<p>The reasons vary, and almost all of them have at least a couple of things that they do very well. But the bottom line is that this exactly the kind of &quot;enterprise software&quot; that is sold to people who will never have to actually use it. They are overwhelmingly sold as ways to increase reimbursement for services provided, as a part of the arms race of insurance companies refusing payment, and hospitals billing more and more.<p>Even in public sector settings that aren&#x27;t billing, the only viable options available are built with this problem in mind.
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cs702超过 4 年前
Doctors hate their computers because the software they are forced to use <i>sucks</i>.<p>And it sucks for the same reason that most enterprise software sucks: because <i>the people who budget for it, choose it, and pay for it are not the people who use it</i>.<p>For more on this, see this now-classic Twitter thread by Princeton CS Prof Arvind Narayanan:<p>&quot;Why Enterprise Software Sucks&quot;<p><a href="https:&#x2F;&#x2F;twitter.com&#x2F;random_walker&#x2F;status&#x2F;1182635589604171776" rel="nofollow">https:&#x2F;&#x2F;twitter.com&#x2F;random_walker&#x2F;status&#x2F;1182635589604171776</a>
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treis超过 4 年前
This is an extremely long article and admittedly I started skimming halfway through, but this statement:<p>&gt;But we think of this as a system for us and it’s not,” he said. “It is for the patients.”<p>Is wrong. It&#x27;s a misnomer to call them medical record systems. They are primarily billing systems. Sure, improving patient care or reducing paper records are nice. But the #1 thing is to document the care to allow them to bill insurance or the government.
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dctoedt超过 4 年前
The author, Dr. Atul Gawande, is more than a bit of a rock star. He&#x27;s a Rhodes Scholar and MacArthur Fellow &quot;genius grant&quot; recipient. He wrote, among other things, <i>The Checklist Manifesto</i>, having headed up (IIRC) a World Health Organization project to implement short, bang-for-the-buck preincision checklists for surgeries, which apparently improved outcomes dramatically.<p><a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Atul_Gawande" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Atul_Gawande</a>
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nitwit005超过 4 年前
I wonder how often people are pissed at the software companies, when the real villain in this story is their hospital. They&#x27;re actually upset at customizations the hospital insisted on.<p>At my last job I tried to get some fields in our bug tracking system made optional. You could run reports showing they were garbage most of the time. Naturally, I failed, and those fields are still required to this day. I started putting &quot;supercalifragilisticexpialidocious&quot; as a value in some of them. No one ever commented on it.
scarier超过 4 年前
Part of the problem: medical software isn&#x27;t designed to facilitate efficient patient care. It&#x27;s designed to facilitate billing.
canadaj超过 4 年前
My first &quot;real&quot; job out of college was database reporting at my local hospital that used Epic. I was young and starry-eyed, but I remember sitting at these Epic trainings and using the software. I knew something must have gotten lost in translation during development, because the software was absolutely a mess of confusing menus and screens. After all, I was a budding software developer with absolute computer literacy, if I didn&#x27;t get it, who would?!<p>I remember thinking that there was no way self respecting developers would allow this to happen, but I was so naive!
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vedtopkar超过 4 年前
Having spoken to a lot of doctors during medical school, it really does feel like a generational thing. Physicians who were trained in the pre-EMR times have a really hard time transitioning. This is partially a UX design failure on the part of EMR companies.<p>The newer crop of physicians have a much better time using EMRs. Don&#x27;t get me wrong, they are acutely aware of the ridiculousness that is modern billing-centric medical records. But having been trained in that atmosphere, it definitely appears less painful to their day-to-day.
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prerok超过 4 年前
&gt; the design choices were more political than technical: administrative staff and doctors had different views about what should be included.<p>I worked at a company that designed such a system. I was not involved with the project but when the system came out there was a lot of heat in the press quoting medical professionals about how bad the system was. Suddenly, with the new system, the workarounds used in the previous one stopped working. The problem, of course, was not in the &quot;programming&quot; part, even if the press portrayed it so. The problem was the requirements and the insanity of the medical management to force the users to stick to the exact documented work process.<p>The article addresses this as well later on and describes how solutions are then added by workgroups for specific fields. Just another example how you should design such a system along with the users and not by encoding work process some administrative entity proscribed.
bigtones超过 4 年前
Epic was a medical records system built up since the 1970&#x27;s in Verona Wisconsin, first developed to turn paper based medical records into a database computer system. A good 8 minute YouTube video from January this year on the sole female founder and the quirky company culture is at:<p><a href="https:&#x2F;&#x2F;www.youtube.com&#x2F;watch?v=8lPMYk09nUg" rel="nofollow">https:&#x2F;&#x2F;www.youtube.com&#x2F;watch?v=8lPMYk09nUg</a>
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jungletime超过 4 年前
I hate my dentist&#x27;s computer. She&#x27;s looking at my xrays on the computer, touching the mouse then my mouth. Should I freak out? What are the odds she autoclaves the mouse between patients.
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jfkdkdnaahhdnd超过 4 年前
I used to work for an EHR vendor. Users don&#x27;t drive features, hospital administrators and CMIOs[1] do. In general, we give hospitals the ability to get better reimbursement from insurance companies by embedding more detailed billing information in the patient&#x27;s chart and documents. We also help shield hospitals from liability by helping add more details demanded by their lawyers. Information about the patient from healthcare providers for other healthcare providers runs a distant third.<p>If your old paper chart didn&#x27;t get misfiled or fall behind the cabinet, almost everything in it was relevant to your care, because there wasn&#x27;t enough hours in the day to record anything else. Now, it&#x27;s a sea of compliance bullshit and autocompleted lies -- the unscrupulous practitioners insert multipage reports on tests that were never performed with just a few clicks. (I think the EHR vendors now also sell tools to detect that sort of fraud.) For users who ultimately want to provide care, dealing with electronic medical records is a nightmarish situation and it&#x27;s leading to burnout at record rates.<p>1. Chief medical information officer --usually a doctor who became an expert EHR user and now decides what will work for doctors and what won&#x27;t.
fullstackmd超过 4 年前
I&#x27;m an MD&#x2F;Dev at one of the only major academic centers in US that still maintains a home-built EHR. Atul Gawande is definitely a giant in healthcare process improvement and a great writer. Many of us were eagerly anticipating what he would do with the Amazon&#x2F;JP Morgan&#x2F;Berkshire Hathaway healthcare initiative and disappointed when he stepped down (<a href="https:&#x2F;&#x2F;www.geekwire.com&#x2F;2020&#x2F;atul-gawande-steps-ceo-haven-healthcare-joint-venture&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.geekwire.com&#x2F;2020&#x2F;atul-gawande-steps-ceo-haven-h...</a>).<p>Unfortunately, there are too few of us that understand both the challenges of caring for patients and the barriers of writing (and maintaining!) good software. Our EHR is far from perfect, but the basic HTML interface has aged remarkably well into the era of smartphones. Our approach is to extend functionality of our EHR with APIs and an ecosystem of add-ons. Always looking for people with a passion for healthcare and flexible skills. Mumps&#x2F;Cache, API design, JS (vanilla, JQuery, React), mobile (Swift, Java, React Native, Kony), and ML (computer vision and NLP).
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xyst超过 4 年前
I am not surprised at all. When I was a college student on the medical school track, there was a unique opportunity to work alongside doctors in a hospital setting. The job was to be the doctor&#x27;s &quot;scribe&quot; and input all of the doctors findings, patient history, and document the care provided by the physician (eg, suture repairs, intubations, and other procedures).<p>It didn&#x27;t make sense why this job existed until I actually started training on the system. The system is absolutely god awful in terms of UX experience, but after awhile (1-2 months) you get acclimated to it and could complete a chart in &lt;5 minutes.<p>Some or most of the doctors I worked with absolutely hated the system itself. On many occasions, I have observed doctors input the wrong orders which if they were performed would have had severe consequences. Fortunately, 99.9% of the time the error was caught by the physician or the nurse assigned to the patient. The one instance where it wasn&#x27;t caught was actually due to human error - nurse gave patient anti-hypertensive med instead of the ordered calcium channel blocker (Cardene vs Cardizem?).<p>On the worst occasion, one doctor I worked with struggled on a daily basis to input orders into the system. I think it would take 5-6 minutes just to input some basic orders. Someone ended up teaching him how to input the orders in free form text and the nurse(s) would just write up new orders based on that (eg, doctor would write a single order as &quot;cbc,cmp,ua r&#x2F;o uti, drug screen, CXR 1v r&#x2F;o pneumonia&quot; and the assigned nurse would recreate the orders in the system in a line-item fashion). Kind of sucks for the nurse, but I think it ended up working out better for both parties.<p>I ended up dropping out of the doctor career path due to this unique and eye-opening experience as a scribe (not because of the EHR software itself but figured the &quot;doctor life&quot; was not meant for me).
jld超过 4 年前
It&#x27;s like asking &quot;Why do pilots hate airplane food?&quot;<p>It has nothing to do with why pilots are&#x2F;aren&#x27;t epicures, and a more to do with their bosses deciding to serve them crappy food.
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cknight超过 4 年前
That medical software is simply bad is also my experience, having been an IT Manager for a clinic management company for a few years now.<p>In Australia at least, 85%+ of medical practices run one of two practice management systems. Both of these systems were originally developed by the same guy, and both have their centre of operations in the same small regional town in Queensland.<p>I don&#x27;t think it&#x27;s a surprise that top-tier developers are unlikely to be willing to move to the middle of nowhere. My experience with the version we use is that its UX is unpleasant, the platform isn&#x27;t reliable, and it doesn&#x27;t perform well at scale for larger clinics like ours.<p>I completely understand that the monolithic design of the software is mandated by too many competing interests (and regulations) for it to be simple. But I am sure it could be better.
Peepers超过 4 年前
Medical professionals in this thread, I encourage you to reach out to the people at your organization making the decisions for your EMR. Escalate, or the development company will never hear about the issues that are hurting you daily.<p>I&#x27;m a developer at one of these companies, and we truly do want to make your experience better. If there&#x27;s a workflow that you do for every patient that takes 3 clicks instead of 1, escalate. There&#x27;s a good chance there&#x27;s build that could help you out. If there&#x27;s not, escalate anyways. Ask your IT department to contact the development company&#x27;s staff. We want to hear any and all feedback about specific workflows that are a struggle.
Farbklex超过 4 年前
Just my 2 cents. I manage the IT for a doctor&#x27;s office and the software they use from a medium size company in Germany has a Word &#x2F; Excel export that looks like this:<p>1. Software tries to open Excel &#x2F; Word (it actually failed to open Excel on a machine, but when I opened it manually, the export continued)<p>2. It copies a row in the software<p>3. It pastes the row into Word &#x2F; Excel<p>4. If more data is available, go back to 2.<p>This is for the export of a data integrity check report in that software suite. It takes multiple minutes to export a report and you can watch live how the copy &#x2F; paste happens. I was amazed that somebody has the balls to sell this and gets away with it.
peterwwillis超过 4 年前
For the medical professionals here who hate their EHR systems: send the CEO, CTO, President, VP, etc of the company some mail describing your problems, how many people hate it, how much time it drains, one or two ideas on how to make it better, and ask them to forward your mail to the product owners. One of them will hopefully forward it down the chain and in a year maybe one of those things will be less painful.<p>Also, a bunch of the people reading HN work for different vendors, so light up the comments about specific problems with specific products and we can take them directly to the people who can fix it.
scythe超过 4 年前
This is probably the most trite argument on any software forum, but based on my admittedly limited experience working in a hospital research environment, Windows is a serious limiting factor for medical practitioners.<p>Not because it&#x27;s a bad operating system, but because hospitals are constantly out of money and computer upgrades are never a high priority. Microsoft does a decent job of backwards compatibility with software, but the hardware requirements keep piling up. Windows has no equivalent of LXDE; the computer in the hallway takes 15 minutes to boot on Windows 7. It&#x27;s a situation I run into over and over: <i>the damn thing is slow</i>.<p>It doesn&#x27;t help that, as others mention, medical software is rarely built with the quality of software engineering we&#x27;re accustomed to seeing. But it can&#x27;t help that the software tries to display all of the information graphically and show as much as possible at once -- pictures I have to wait to load even if I don&#x27;t need to see them. This comes back, probably, to how it&#x27;s sold: look at this impressive flashy window with all these bells and whistles. Never mind the system resources, and don&#x27;t get me started on wasting screen real estate. My workflow begins: turn on the computer, wait, log in, wait, open SNC Patient, wait some more...<p>I don&#x27;t know how many billable hours are spent waiting for computers to load, but it can&#x27;t be trivial.
dang超过 4 年前
Discussed at the time: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=18381969" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=18381969</a>
hollosi超过 4 年前
Medical software is terrible, because healthcare is very expensive, and this is the only effective cost control.<p>Since the payers (insurance companies and the government) want to avoid seen making medical decisions, their only way to bring the cost down is to slow down the providers.<p>Therefore, they do not allow automation in the EMR&#x2F;Health software. This is not a joke: for appropriate billing, the physician has to go through an elaborate dance of clicks, and write and rewrite fields with the same content, personally. In other words, if it was automated, or if the office staff filled those out, then the billing would be much lower.<p>It&#x27;s not true software vendors would not be able to automate a lot of this, but they just can&#x27;t, because the physicians are required to work in a manual way for proper reimbursement.<p>It&#x27;s a strange world, where a doctor who is a faster typist makes more money...<p>It&#x27;s very sad, but unfortunately it&#x27;s working, at the cost of driving physicians to the edge of insanity.
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gok超过 4 年前
Paper medical records were great for doctors. They made it really hard to switch providers. They were a great excuse for medical errors, or for &quot;accidentally&quot; ordering expensive redundant tests from their buddies. EMR had to be legally imposed on doctors because otherwise they would still be gleefully killing people through bad handwriting.
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nikanj超过 4 年前
Kids who go to med school tend to be the ones who excel in math, chemistry, and similar ”logical thinking” subjects. They usually do reasonably well with computers.<p>In my experience, the contrast is stark to another high-paid professional group: lawyers.
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mitchbob超过 4 年前
Keep reading this excellent article, and you&#x27;ll get to what for me was the best part, about the power of co-design:<p>&gt; Some people are pushing back. Neil R. Malhotra is a boyish, energetic, forty-three-year-old neurosurgeon who has made his mark at the University of Pennsylvania as something of a tinkerer...Soon, he and his fellow-tinkerers were removing useless functions and adding useful ones. Before long, they had built a faster, more intuitive interface...Malhotra’s innovations showed that there were ways for users to take at least some control of their technology—to become, with surprising ease, creators.
brendawalsh超过 4 年前
So, HN doctors here, how ‘computer literate’ are your colleagues?<p>I have worked with doctors of varying age groups, including family, and it really just depends. Age is not a factor, it seems some people are averse, and others passionate.
annoyingnoob超过 4 年前
Is there any one-platform-to-rule-them-all solution, that will support 70K users across hundreds of sites, that doesn&#x27;t look and work like a clunky piece of junk?<p>Maybe the one-solution model isn&#x27;t the best option.
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viraptor超过 4 年前
This is also an amazing space for shadow IT and customisations. Probably the best ROI software I wrote were AutoIT scripts for medical software. Plug them into StreamDeck and they&#x27;re saving amazing amount of time. On a single case it&#x27;s just a few tens of seconds, but it really adds up over time. (Think one button specialist referral which clicks through &#x2F; fills out 4 windows)<p>Then there&#x27;s mass-edit scripting. Have you ever told someone that you updated 200 records and added $4k income, while saving 4h of manual error-prone clicking?
LoSboccacc超过 4 年前
the epidemic has been a boon for the digital transformation of doctors here in Italy.<p>turns out you can do take appointment at the gp, it wasn&#x27;t impossible<p>turns out you can request exams trough email, it wasn&#x27;t impossible<p>turns out you can have a pre-screening via photo and messaging apps, it wasn&#x27;t impossible<p>turns out you can safely deliver prescription trough digital channels to both the person and the pharmacist so that you can just show up with your healthcare number and take the drugs home<p>it has been dragging medics and other professionals around then into the present kicking and screaming
testfoobar超过 4 年前
How are hospital records and billing managed in European countries?
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AnimalMuppet超过 4 年前
TL;DR: Doctors don&#x27;t hate computers. They hate medical software, because it&#x27;s done badly. It gets in their way with pointless (to the doctors) bureaucratic trivia that the doctors shouldn&#x27;t have to care about.
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mmaunder超过 4 年前
I was startled back in 2015 when a world renowned oncologist got chatting with me about github and tinkering with code. I think it depends on one’s appetite for technology.
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giantg2超过 4 年前
The big part of this issue is how lawyers and politicians make everything more complicated than it needs to be. Doctors can&#x27;t access the data they need, require multiple forms and signatures for simple things (like transferring records), and are stuck in old school tech &#x2F; jurisprudence (can I email a scan? Oh, it has to be fax).<p>Don&#x27;t even get me started on the format of VAERS data...
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jbj超过 4 年前
I tried a &quot;EPIC similator&quot; at a medical museum, it was a bunch of drop down menus combined with slow loading pages I could navigate between.<p>I get an impression that hospitals are wasting many expensive workhours from highly trained professionals to operate these types of systems. I really wonder if it could make economic sense to let MDs have personal assistants for these purposes.
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caycep超过 4 年前
Saying as someone who has to run several different EMRS from 10 different hospitals in a weird hellstew of citrix and VMWare Horizon clents...I would kill for someone to write a stripped down front end that runs natively in iOS&#x2F;Mac OS or the web (assuming a good recent web app library)..
Aeolun超过 4 年前
One of the things I think would still be super interesting to try and set up is private single payer health insurance in the US.<p>If we cannot get the government to do it, we should just do it ourselves.<p>The only issue is the absolutely massive upfront investment necessary :&#x2F;
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rukuu001超过 4 年前
Looks like doctors (or most of them) didn&#x27;t get a look at this until it was done?<p>In a field as technical and regulation-laden as medicine it&#x27;s hard enough as is. Without relentlessly validating it with users it could only go in one direction.
brundolf超过 4 年前
Relevant: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=21224209" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=21224209</a>
moonbug超过 4 年前
Hey America, get yourself some healthcare infrastructure.
desmap超过 4 年前
It&#x27;s not about medical software but about how big the lock-in is (which is always higher with B2B). The higher the lock-in the worse the overall UX.
acd超过 4 年前
I think that Parkinsons law applies to all form of administration tasks including doctors and hospitals. &quot;Parkinson&#x27;s law is the adage that &quot;work expands so as to fill the time available for its completion&quot;. It is sometimes applied to the growth of bureaucracy in an organization.&quot;<p>Parkinson noticed that the English ship fleet was decreasing in numbers but the number of administrators administrating the fleet was increasing. This rule can be generalized and said to adhere to all kind of public work. If we do not keep Parkinsons law in check doctors will spend more time at computers fulfilling rules administrators invented instead of doing real critical work helping sick patients. Our tax burden will also increase since the efficiency of the system goes down over time, more tax money needs to be allocated to serve the rules and laws the administrators have invented. Is critical that we limit the number of rules and laws administrators can invent so that we have efficient system that serves there original purpose.<p>Parkinson&#x27;s law is the adage that &quot;work expands so as to fill the time available for its completion&quot;<p>Key take away passage from Parkinsons law: &quot;The accompanying table is derived from Admiralty statistics for 1914 and 1928. The criticism voiced at the time centered on the comparison between the sharp fall in numbers of those available for fighting and the sharp rise in those available only for administration, the creation, it was said, of &quot;a magnificent Navy on land.&quot; But that comparison is not to the present purpose. What we have to note is that the 2,000 Admiralty officials of 1914 had become the 3,569 of 1928; and that this growth was unrelated to any possible increase in their work. The Navy during that period had diminished, in point of fact, by a third in men and two-thirds in ships. Nor, from 1922 onwards, was its strength even expected to increase, for its total of ships (unlike its total of officials) was limited by the Washington Naval Agreement of that year. Yet in these circumstances we had a 78.45 percent increase in Admiralty officials over a period of fourteen years; an average increase of 5.6 percent a year on the earlier total&quot;<p><a href="https:&#x2F;&#x2F;www.economist.com&#x2F;news&#x2F;1955&#x2F;11&#x2F;19&#x2F;parkinsons-law" rel="nofollow">https:&#x2F;&#x2F;www.economist.com&#x2F;news&#x2F;1955&#x2F;11&#x2F;19&#x2F;parkinsons-law</a> <a href="http:&#x2F;&#x2F;www.berglas.org&#x2F;Articles&#x2F;parkinsons_law.pdf" rel="nofollow">http:&#x2F;&#x2F;www.berglas.org&#x2F;Articles&#x2F;parkinsons_law.pdf</a> <a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Parkinson%27s_law" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Parkinson%27s_law</a>
longtimegoogler超过 4 年前
Doesn&#x27;t everyone hate their computer? I know I have a love hate relationship with them.
xchip超过 4 年前
Could anyone post the answer? I am sure it can be stated in three sentences.
sabujp超过 4 年前
tldr; information overload, reduced actual time with patients and increased time entering bunch of information into computers, summary from <a href="https:&#x2F;&#x2F;autosummarizer.com&#x2F;" rel="nofollow">https:&#x2F;&#x2F;autosummarizer.com&#x2F;</a> :<p>My hospital had, over the years, computerized many records and processes, but the new system would give us one platform for doing almost everything health professionals needed—recording and communicating our medical observations, sending prescriptions to a patient’s pharmacy, ordering tests and scans, viewing results, scheduling surgery, sending insurance bills.<p>But three years later I’ve come to feel that a system that promised to increase my mastery over my work has, instead, increased my work’s mastery over me.<p>A 2016 study found that physicians spent about two hours doing computer work for every hour spent face to face with a patient—whatever the brand of medical software.<p>My hospital had to hire hundreds of moonlighting residents and pharmacists to double-check the medication list for every patient while technicians worked to fix the data-transfer problem.<p>“Now I come to look at a patient, I pull up the problem list, and it means nothing. I have to go read through their past notes, especially if I’m doing urgent care,” where she’s usually meeting someone for the first time.<p>Many scientists complained to Spencer in the way that doctors do—they were spending so much time on the requirements of the software that they were losing time for actual research.<p>In 2014, fifty-four per cent of physicians reported at least one of the three symptoms of burnout, compared with forty-six per cent in 2011. Only a third agreed that their work schedule “leaves me enough time for my personal&#x2F;family life,” compared with almost two-thirds of other workers.<p>There are messages from patients, messages containing lab and radiology results, messages from colleagues, messages from administrators, automated messages about not responding to previous messages.<p>Previously, she sorted the patient records before clinic, drafted letters to patients, prepped routine prescriptions—all tasks that lightened the doctors’ load.<p>She called it “a ‘stay in your lane’ thing.” She couldn’t even help the doctors navigate and streamline their computer systems: office assistants have different screens and are not trained or authorized to use the ones doctors have.
tus88超过 4 年前
A lot of in-house medical &quot;software&quot; is Access databases so no wonder really.