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.

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