Skip to main content

First, do no iHarm

In this post, I will be commenting on the New Yorker article “Why Doctors Hate Their Computers” by Atul Gawande, from November 12, 2018. It focused on doctor’s frustrations with the transition to Electronic Medical Records, or EMRs.

Learning about this it has been surprising how painful the transition process has been. I have heard similar complaints from friends in the field, but I did not know how widespread it was.

By the sound of it, it is hundreds of little reasons that make the doctors’ lives harder. For one, it is much harder to add a simple note to a patients’ file. There is a lot of unnecessary information  that needs to be filled out, and many of these fields are mandatory. Another reason is that the computer gives the doctor arbitrary limits, like they cannot view lab results from a week before because their window for viewing it has expired.

Yet another reason is that the user interface is not very user friendly. It takes several more clicks than it should to do any one thing. The list of complaints seem to be endless, and unfortunately the issues brought up in the article are likely just the tip of the iceberg.

The real customer for the system is certainly not the two groups that would ideally benefit the most — the doctors (and nurses and the like) or the patients. It has made the doctor’s jobs much more difficult without much to show for it. The strain that it puts on the doctors are felt by the customers as well. There might be a few advantages, but most are marginal at best.

No, the real customer is the creator of the EMR systems. They stand to profit from it quite a bit. The fact that they were ridged to any outside influence to make the system better shows their true motives.

The lessons from the implementation from this system most certainly do not only apply to the Electronic Medical Record systems. The article touched on one of the patient’s experience in his own life working in construction. He echoed one of the complaints of his doctor, which was that the automated alerts created a signal fatigue, and the solution is to do the old school way of going back to picking up the phone over using the computer.

When I read about the doctor not being able to submit a form unless all the fields were complete, I thought about when I worked at the YMCA when I was sixteen. There was an extensive incident report that took forever to fill out, so consequently, we never used it save for major events. Of course, these were still done on paper, but if a paper could get in the way of doing our job properly, I have no doubt a much more complicated system would as well.

This reading has not changed my opinion because I was already aware on the topic. I have read up on it in the Boston Globe, and I have talked about it with friends who are in the field. The New Yorker article just confirms everything I have already thought about it.

I was hoping the article might forecast what might come. As they are now, EMRs are awful, but they are here to stay. They have only been around for a little over a decade most places. This is just the natural growing pains we have to get through in order to get to something that benefits us all.

Comments

Popular posts from this blog

Pattern “Read Constantly”

The apprenticeship pattern I decided to choose for this week’s blog was “Read Constantly.” It was somewhat self-explanatory, but I thought it had some good insights nonetheless.

It recommended reading books over blogs. I would imagine that this is the right course of action from researching blogs last semester. All the material was good and informative, but many times when the host was interviewing someone, it felt like a summary of what could be a very interesting book. There’s only so much that can be gained from a blog post or a podcast. The things that you learn from those can be valuable, but it is better to go deeper when possible. Even if you have a very wide base of knowledge, it will only get you so far when you only scratch the surface.

The quote at the very beginning, from Steve McConnell, says that if you read a good programming book every other month, you will distinguish yourself from your peers. This seems like a worthwhile task, and frankly it is very doable. He chalks…

Shailesh Rao on Quality Assurance

In this episode (number 219) of “Test Talks,” I was able to hear Shailesh Rao’s insight into having quality software. He compared it to a “paper-free office” or a “stress-free life,” both worthy goals, but are hard to achieve. They can be strived towards, but it is near impossible to get it 100%.

He brought up the issues that bad software can pose to potentially millions of users. Bad software can open the doors to hackers, who might be able to take down websites like Twitter or Reddit. Also, it might stop airlines from being able to function — an annoyance to most, but Mr. Rao asked, “what if there was time-sensitive and lifesaving medicine onboard?”

I found this podcast brought up some aspects that I had not thought of before when if comes to quality assurance. I suppose that I’ve thought about the various things he brought up, but as a consumer and never as a creator of the software.

A very thought-provoking topic brought up was the fickleness of consumers. They don’t have the pati…

Quality Assurance as a Career

I decided to take a somewhat different tack for this week’s post for software quality assurance and testing. Instead of focusing on testing itself, and all there is to it, I found a video from a tester in the field, Alan Richardson, on his advice for someone who is interested in getting into the field.
He strongly urged someone getting started not to think of a position in quality assurance as a “stepping stone” to being a software developer. If you do, you will inevitably find yourself in a dead end because you really aren’t interested in the field. “If you want to be a software developer, start as a software developer.” 
He encourages the viewer to read everything they can on the subject. A lot of it is free, so there is no reason to necessarily buy anything. However, he gives some book recommendations. He gives a good insight why books can be so valuable to learning. “An expert in the field took a year to concentrate everything they know into those pages,” (paraphrased).
He doesn’…