Robert M. Wachter has spent a tremendous amount of time studying the complex — and sometimes troubled — relationship between technology and health care. For him, finding the common ground between the deeply human essence of providing care, and the capabilities of big data to improve lives, creates a fascinating challenge.

At the 12th Annual World Health Care Congress, March 22nd - 25th in Washington, D.C., Dr. Wachter will share a panel with other industry thought leaders as they explore health IT from a variety of different perspectives.

DOTmed News recently spoke to him about what attendees can expect from that event, and how conducting research for his upcoming book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, paved the way for his participation in the World Health Care Congress.

DOTmed News: How did you become involved with the World Health Care Congress?

Robert M. Wachter: In the process of writing my book I became quite interested in how technology was transforming the world of medicine, and I interviewed about 100 people ranging from national policy leaders to front-line physicians struggling with their computers.

The World Health Care Congress contacted me because they thought I would be a good candidate to moderate a session about health IT. Although I’m not a technological expert, having spent a year of my life diving deeply into the world of technology, I think I now know more parts of the elephant than virtually anybody.

DOTmed News: What topics will you be addressing in your session?

RMW: There will be a few of us sharing different views on health IT.

John Niederhuber is a cancer surgeon and former head of the National Cancer Institute and now running a large genomics research innovation center. Bryce Williams is a CEO of a start-up focusing on wellness and use of data to improve health, and Victor Dzau is the president of the Institute of Medicine and formerly ran health affairs at Duke.

So, it’s a broad reaching panel, and my own bias here – the reason I got into this topic and wrote the book – is that I looked at the world of health technology and it strikes me that we’re in an extraordinarily interesting time.

Largely because of the $30 billion in federal incentives that have been doled out over the last four years, we have become a digital industry. Remarkably, until that time, most health care transactions were done with pen and paper, and fax machines and clipboards, and now 70 or so percent of hospitals and doctor’s offices are computerized.

I got into it because the things I saw written about that topic were way too technical, or a little too hyped-up for my tastes. I don’t think people were appreciating the reality of how hard it is to become digital and how many unexpected consequences there have been. I wanted to describe that in a way that was not Luddite — in a way that basically said: this is important. It’s right. We have to become a digital industry, but we also have to understand in a much deeper way what some of the consequences of that are.

So the session will explore those issues. As we all talk about the magic of big data, what of it is real and what is hype? What does the doctor of the future look like in the digital environment? Are we going to need doctors at all? Patients have massive access to data that they never had before — pertaining to their own conditions and labs and X-rays — and many can read doctor’s notes. Meanwhile, many have co-pays and deductibles that make them think twice about using traditional health care systems and doctors.

Is that good or bad? What is the role of the doctor in that new environment where they’re not the only fountain of information and insight for patients? What is the role of genomics in all of this?

The other speakers and I had a phone call recently where we kind of explored what we were going to talk about and we all just wished we taped the conversation because it was incredibly interesting and we’re coming at this from a lot of different angles. Some of it will be very tech oriented but some of it is kind of intensely human, which I think is the most interesting piece of all this.

When the travel industry went digital and when the bank industry went digital we all said, 'Fine, do we really need to see travel agents and bank tellers?' No — and that’s OK. But health care feels different and there’s something intensely personal and deeply human about it, so how do we get that balance right between the tech where it’s very useful and important, but also not forget that we’re dealing with scared, anxious human beings?

DOTmed News: In what ways is the World Health Care Congress an important event for the health care industry?

RMW: It’s a pretty visible conference that brings together a lot of very senior policy makers. The attendance tends to be well over 1,000 and — because it’s in D.C. — a good proportion of people have central roles in the industry and the delivery system.

It's an important setting where the right people will exchange ideas about interesting issues in an industry that’s undergoing more rapid change than any time that I can remember in my 30 years in it.

DOTmed News: What do you hope your session will leave people thinking about?

RMW: I hope the takeaway is that technology is rapidly advancing and it’s really cool, but the question of whether or not it works has as much to do with the decisions that human make — the way we use it and organize our work — as it does with the actual technology.

One of the things I learned while writing my book was that there’s something called the productivity paradox where everyone talks about how wonderful technology will be — and how it will transform any given industry and make things better — but in the first ten years it’s like, 'What happened? It hasn’t worked the way we hoped it would, there have been unanticipated consequences, and it hasn’t led to the productivity gains we hoped for.'

Usually the benefits begin showing up around year ten or so. The reason it takes that long has surprisingly little to do with the technology getting better. Instead, it’s the people doing the work need time to learn how to use the technology as a tool; learn to change their culture, change their habits, change their workflow. Only then does the technology become useful in the way everybody hoped for.

I think we’ve gotten a bit spoiled by iPhones and iPads, you pull the iPhone out of your pocket, you download an app, and you’re good to go. You don’t have to read the instructions anymore, it’s just so intuitively obvious.

But health care is not like that, health care is not finding your nearest Starbucks, it’s really so much more complex than that. I think we have under-appreciated the sort of sociological and adaptive changes that are necessary to make technology sing in health care.

That’s a big part of what we’ll be exploring in the panel, some of the areas where technology is helping and where its promise is fabulous — but also, what are the changes that we all need to make in policy and workflow and culture and organization? What changes do we need to make in the way we think about data and the new role of patients in re-making the health care system? I think that’s where we are.

There was one way of organizing and practicing medicine in the analog world — and it’s not like we were spectacularly good at it — but at least we understood it, organized ourselves, and trained people around it. I think practicing medicine in the digital world is essentially a different beast and fixing that is not merely a matter of better tech. It’s a matter of changing everything around the tech.