Seth Godin has written an interesting observation about a common experience of hospitals in a piece titled Pre-Digital:

A brief visit to the emergency room last month reminded me of what an organization that’s pre-digital is like. Six people doing bureaucratic tasks and screening that are artifacts of a paper universe, all in the service of one doctor (and the need to get paid and not get sued). A 90-minute experience so we could see a doctor for ninety seconds.

Wasteful and even dangerous.

He goes on to imagine what the experience would be like if everything were digitised. Everyone would know what’s going on without having to ask ten times, basically. “The entire process might take ten minutes, with a far better outcome,” he suggests.

I like a lot of what Seth has to say, but on this its worth really asking if it would be the picture he imagines. Given the UK’s £11bn pretty useless attempt at this, I’m not so sure. Sure, a well-conceived and integrated digital patient system would seem like a dream, but large, government I.T. projects are never well-conceived and integrated. They are mired in over-wrought requirements documents that are miles away from actual human needs, frequently taken on by companies that under quote to get the job and then blow out the budget and schedule later. The UK NHS project also ended up in a nightmare of privacy issues.

What Seth is arguing for here is really the classic “we need more technology to solve this problem” approach. It’s something that has served him well with many of his projects, like The Domino Project and it’s particularly an American approach to the use of technology. But the technological solution he describes masks the real need. The need is for a well-conceived and integrated system of communication and a quicker journey through the hospital system (a need and an organisation which, in turn, have their own underlying needs). It seems likely that digital tools and networks would play a part in this, but it’s by no means a given.

Had I not have had my own copy of an X-Ray (okay it was on my iPad) at the hospital recently, we wouldn’t have been able to access the one the specialist gave us (in a proprietary format) on CD because the hospital’s radiology computer had crashed and they had to wait two hours for the I.T. guy to come and fix it.

Sometimes a whiteboard is the most efficient or usable way to display who is on duty or who is to be operated upon. It doesn’t flake out due to a system error, doesn’t go down when power fails and requires active effort to delete and change a name, not a typo or entry in the wrong field.

They are tools only. The question to ask when considering what the best drill is should really be, “how can we make holes?” or even “do we need holes here?”

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