This week, our class was asked to read the following article, “Why Doctors Hate Their Computers” by Atul Gawande, which discusses the adaptation of healthcare professionals transitioning to a more digitized system to perform care. When Epic, a highly popular electronic medical record software, started to become more prevalent in hospitals and other healthcare settings, the costs of deploying the system on such a widespread scale had to be considered, not only for patients and especially for the healthcare providers who had to learn how to properly use the system.

After reading the article, I thought about how much time my own healthcare providers spend documenting on their computers, because I honestly hadn’t really thought about it before. Most, if not all, of my providers do in fact take a decent amount of time before, during, and after my appointments to work on my medical record. So, it was really eye-opening to read about the various clinicians who take lots of time outside of their workday to learn and use the system, not only because of the number of patients whose information is stored, but also because of the amount of time it takes to become fully acclimated to the extremely versatile software. It must certainly become exhausting to lose more time outside of work, after already having obscenely long workweeks.

That being said, I think that the primary tension that caused the system to make the doctors’ lives harder is the sheer number of patients who need to see a physician, along with the amount of pressure to become proficient with the new system at the same time. Each healthcare provider already has an obligation to visit as many patients as possible. They barely have time as it is outside of each appointment for documentation. Adding another responsibility of being comfortable with the new electronic medical record software (which has a function for just about anything related to health documentation) is definitely a hefty task.

With all this in mind, I feel that the true customers of the system are both the patients and the clinicians. While Gregg Meyer from this article described the patients as the real customers (because the number of patients accessing their records far surpasses the number of providers maintaining the records), it is also imperative that the healthcare providers fully understand the system. While each patient can spend several minutes examining their record, each provider spends hours per day working with many different patients’ records. With this much time spent, I feel that it should be argued that in fact, the providers are the customers system.

I think that some of the lessons described from this article could really be applied to any organization that may be switching to a more digital setting. The cost of familiarizing everyone with the system, both in cost of time it takes and the financial burden of training, can become high. These should all be taken into consideration when digitizing a company.

My main concern with such high dependency on these electronic medical software lies in the risk of some sort of organizational shutdown, should the system fail at any time. Because there is always high traffic due to the massive demand, these sorts of risks should be kept in mind. This software is revolutionary to the development of quality healthcare, but ensuring that the organization as a whole can still be successful in the case of malfunctions is essential.

From the blog CS@Worcester – Hi, I'm Kat. by Kat Law and used with permission of the author. All other rights reserved by the author.

This blog is about the article “Why Doctors Hate Their Computers” by Atul Gawande, from the November 12, 2018 issue of The New Yorker. This article gives inside experience from doctor’s perspective about software system in the medical field. There are a lot of interesting point in this reading, its touch on point of view from the hospital admission, doctor and software designer. How each department want the software system to benefit them, while there is conflict between. In this reading, I understand where they are coming from and their difficulty adapting to the system. Most of the points in the article are from doctor’s perspective on software, and I am reading as the software developer. This is useful to understand from the customers. We as the developer, listen and understand from customers is crucial. We need to know how to make software useful and convenience, without too much hassle of using it.
The first point of the tensions caused the system to make doctors’ lives harder, the software release in large-scale at one time. Everyone in the hospital must attend hours of mandatory computer training. Most of attendant don’t want to be here, while they need their time to doing their actual job. Time is one of the important in the medical field, one doctor job to see and treat many patients. Rather meet patient face-to-face get personal, they are on computer checking the list. One system does not work for every doctor. Each doctor has their own way of working. System should be release and update slowly as developer work with the hospital/doctors.
The system design to benefit everyone, but I feel the real customer for the system is not just the doctors. The administration wants to keep track with all the work, the choices were more political than technical. The patient benefit from check list of safety hospital must do, but their records are not connecting between different system. They must answer same question every different visit. The doctors are the last people who are benefit, it seems while they are the operator, they have to follow the system. They must change their way of work to be beneficial to the system.
The lessons from the implementation of this system does not apply to only Electronic Medical Record systems. These lessons apply to all software development, how to find the balance of beneficial and drawback. The reading does show more interesting details that I didn’t think of. There are no big parts that I disagree of, there are lot of points from the doctor’s perspective. There is seem like two sides, I want there is mix between developers and users in make these systems. Less political and more of work together, time is important to doctor so make time use on computer similar to the amount time that they normally spend. Flexible software, we have AI smart enough to learn the way of individual doctor work. We have Google Assistant work for every phone why not work for each doctor. Look at the habit of individual doctor and build base on it. Doctor need to help developer to understand and find the solution that benefit both. The system should just an add-on to the existed work, the main idea is to support not to change.

From the blog CS@Worcester – Nhat's Blog by Nhat Truong Le and used with permission of the author. All other rights reserved by the author.

After reading “Why Doctors Hate their Computers” by the New Yorker my opinion on the topic has changed a bit. I’m sure everyone has gone to the doctors before and waited much longer than they were supposed to due to the doctor running late or some other issue. Leading many to believe that Doctors never run on time when you want them to, especially for your appointments. Now I can see why Doctors are late so often or overburden with the amount of data that they are required to enter in for each patient into a system that could be difficult for them to use on their own or are not the best at it. The whole piece was very interesting and enlightening honestly on the matter of new software for Doctors and the process of learning/switching over from a familiar one. One thing I found interesting was the hiring of scribes to start writing/doing most of the computer work for the doctors themselves to help “remedy” the inconvenience of doing so. The results from this were surprising as well with it actually being very effective but not solving the problem for the doctors themselves almost just beating around the bush. The tension between learning the new software and putting in all the information that they had previously been able to. What I mean by this is three nurses may write three different diagnoses for the same person in the system causing a mass confusion for the doctor. Or in other cases the system wouldn’t allow every detail that they wanted to add like they would do in a handwritten fashion. The lesson from the implementation of this system apply to almost any new system implementation throughout any workplace honestly. Speaking from a personal experience, at my Part Time Job at Lowes they introduced a new system called Sterling for the customer service desk. This system was to replace the old system of how internet orders were placed, tracked, and overall managed. Now I do not work customer service, I work over in the lawn and garden section but after hearing from coworkers and such I know how difficult it was for people to make the adjustment to sterling. The system was alien and overwhelming to all workers even those who knew and used it prior to our store. They all learned some tricks around it and finally learned to cope with it fine with occasional hiccups here and there. So a new software implementation issue isn’t just unique to medical care systems / work spaces. The real customers of the systems are those that have to use the system on a day to day basis, trying to get the most out of their own system even it means wrestling with it. Overall this article was very enjoyable to read while also shedding light onto new topics I had previously been unaware of.

From the blog CS@Worcester – Matt's Blog by mattyd99 and used with permission of the author. All other rights reserved by the author.

Hello and welcome back to benderson’s blog, today is a very special day as I’m uploading a second blog but this blog has nothing to do with the patterns that I have been discussing lately, this blog will be about an article I read that talks about why doctors hate their computers. I know this sounds weird but it is a common occurrence with doctors, I actually go to a doctor who constantly talks about how she hates her computer and that it annoys her when it doesn’t work how it is supposed to. Anyways this article was very long but also a good ready and I would like to share my opinion on the article with you guys.

The article had a lot of thought provoking ideas and explained how the computer systems had pros and cons to them in the medical field and how the doctors used them. I found it interesting that doctors were spending about double the time putting information into the computer for their patients. I also thought it was interesting and sad that family physicians were experiencing depression and suicidal thinking after having to do eleven and a half hours of a day of work. When the article was talking about scribes, I thought that was a good solution to a time consuming problem because that would save a lot of many hours copying and putting information about a patient into the system. As the software was being upgraded, simple tasks that would only take about two clicks were jumping up to eleven clicks to complete the same task which is weird since a system update is supposed to make things usually quicker and easier. The tensions that made the doctors lives harder rather than easier from the system were the things that I previously stated which were that the software made things that used to be easier difficult to put into the system and more time consuming. This caused the doctors to become more stressed out and made their days longer than usual, it did make getting to medical records most of the time faster, just a couple of clicks instead of going through a whole bunch of papers but for other things, it made them way harder to do.

The real customer for the system was for the patients and not the doctors. The reason I think this is because the problem for the doctors is implementing all the symptoms and medical problems that the patients have and it is a very patient centered system where the only thing a doctor really needs about themselves is who they are taking care of and their credentials. This system is basically a “all you know about” your patient, so the system is for doctors but the real customer’s are the patients.

The lessons from the implementation of this system do not only apply to Electronic medical record systems as this happens with basic databases that contain information about a work place and their clients. A business could have a very similar based framework for the clients with certain attributes like a patient would have for a hospital, and implementing these certain attributes could be as a pain as a butt as it is for a doctor to do it for their patient. The reading has made me more aware of the problem with computer systems and doctors but doesn’t really change my opinion of the topic as I think it is useful in the long run to have everything stored in a system, just that it may need some tune ups to make it faster and easier for the doctors. One thing I would say that would be a problem with a computerized system is that if the computers go down for a period of time, you would have to revert to the physical form to make sure you have everything on a patient before hand. All in all though, “Why Doctors Hate Their Computers” does have some interesting points on why doctors hate their computers and very reasonable ones at that but in the long run, having a computerized system is beneficial for more efficient and faster help for patients.

From the blog CS@Worcester – Benderson's Blog by Benderson's Blog and used with permission of the author. All other rights reserved by the author.

As we all progress through the software development track, learning new skills and how to implement solutions to modern problems, we rarely stop to evaluate how our work or programs we create will affect other people. Yes, we have goals of efficiency, security, and user friendliness which guide us to develop the most useful technologies we can. However, even in following all of our rules to a T, we may create unforeseen consequences on the clients we develop for.

This article Why Doctors Hate Their Computers is a great demonstration of unintended consequences of modern software development as it behaves in the real world, being used on a large-scale. Essentially, the article describes a new electronic medical record software called Epic, whose goal was to create a single interface which doctors, patients, and hospital staff can share information and carry out their work more efficiently. The problem with this software was the scale of which it was being implemented. The upgrade from the old system was just too big with too many factors, and the robustness of the program actually served to make medical professionals jobs even harder and more tedious than before.

While they described Epic’s features and goals, my first impression was that it seemed like an excellent idea. Take all of the doctor’s online work tasks, bring them into a single program where patients and hospital staff can add information; it seemed like a grand unifying software that could easily be an industry standard. However, as I read the author’s experience with the hospital actually implementing the software, I became less convinced.

One aspect of this implementation which shocked me was the hospitals plans to compensate for the reduction in productivity that would accompany any large-scale change. According to the author, his hospital group allocated $1.6 billion on the transition – while the cost of the software itself was around $100 million. The majority of the cost was either being paid out to IT professionals who would install and train staff, or wrote off as lost patient revenues from temporary loss of productivity. This is a tremendous amount of investment to get the systems updated. The problem was with the scale of implementation. A possible solution is having “ambassadors” implement the change and then train the rest of their coworkers would be a better system. At least this way people could ease into the transition and get feedback.

This astronomical cost would be arguably worth it if it really cut down on the complexity of the existing system and resulted in a more efficient experience for the customers and a better workday for the staff. Unfortunately this wasn’t the case. The author’s colleagues experienced frustration, cluttered data, and longer hours at the computer. Significant time and energy that should have been given to the patients were now being spent on learning and/or fixing the system, which defeats the purpose of the upgrading the system in the first place.

Though the developers aren’t necessarily to blame. Without a first hand understanding of the needs and bottlenecks of the medical industry, developers rely on our tried and true model of efficiency, which may unintentionally have the opposite effect if complexity becomes too much. Large scale software updates like this should be taken slowly, where developers work closely with clients to fully understand their needs. When the system is ready to be released, it should be live tested with a few “ambassadors”, who can give constructive feedback and train their coworkers, rather than a company wide transition that can be exorbitantly expensive and time-consuming.

From the blog CS@Worcester – Bit by Bit by rdentremont58 and used with permission of the author. All other rights reserved by the author.

For this week, I have decided to read also “Why Doctors Hate Their Computers” by Atul Gawande. The reason I have chosen to read is because in the world we live in now, we have people that are struggling with the changes towards their job aspects and having to deal with problems that are rather unfavorable to an extent. I believe this article will help me understand from a perspective in making sure the problem is clear and finding out what is the real source of it.

What I think is useful from this article is that the perspective can give a similar scenario that which people can relate to learning and end up become frustrated. So let us say that we have a task that is completely new to our workload and it turns out it is in an another language. It is true that we have just to get some help to translate them, but what if it is another language you must learn prior to that? This is the same from this article when it comes to doctors forced to work with unfriendly software.

What I think is harder from the system is the EMR being reliable with good physician input. Learning what medication to give is easy with enough practice and knowing it is. But getting the records needed is very difficult considering it is just a faxed report. The real customers for this system would be those who need of accommodations. This is because as a community, we tend to have options like sending by email instead of verbally, doing things by paper, giving checklists.

The lessons in this article not only applied to the Electronic Medical Records System but also to all technology that requires records. With the lessons, they should make sure that with whatever technology gives the records as requested instead of being just a general report as part of the system. From reading most of the article, I will say it has definitely changed my way of thinking to the medical record system in hospitals. In the past, I usually think it would be on point with learning what medicine to take and what conditions patients would have but now from this perspective, I can understand why doctors would be frustrated in the updating technology to find records needed.

What I think from this article I will disagree is the purpose of EMR being the best thing to turn to for the sake of getting records. I believe that the EMR is meant for billing instead of medical records since it does feel like it takes the amount of time in seeing the patients, which is important. It could be also medical errors that can lead to false information by the responses the patient gives when diagnosed. For this reading overall, I will say this is a good read in learning the perspective of doctors with technology. This one I believe can be difficult at first to get used to since it is from a perspective, but it provides information that relates to technology that constantly change across.

Link to the blog: https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers

From the blog CS@Worcester – Onwards to becoming an expert developer by dtran365 and used with permission of the author. All other rights reserved by the author.

After reading the article on “Why Doctors Hate Their Computers” I found the use of scribes for doctors to be rather interesting. The patients and doctors were both missing out on valuable face to face time because of the tediousness of the software and the constraints of the system. I was shocked to find out that the scribes were making minimum wage in most cases as well as the turnover rate to be as ridiculous as most of them only lasted mere months. I feel that if the pay was increased, the position would be drastically beneficial for both parties involved. The doctors would be relieved of their note-taking duties for the most part, while the scribes, who were often med-school students, or those seeking medical schooling, got some hands on experience in a doctor’s office. This goes without saying that the additional patients per doctor that was happening to the example in the article, defeats the whole purpose. The whole struggle to finding a happy medium between functionality and feasibility for clients is not limited to the world of medical software but a struggle that exists in almost every avenue of software, even the consumer market.

One of the biggest tensions for the doctors is the concept of getting to the next patient as quickly as possible, while maintaining a personal relationship with patients, all at the same time maintaining the monotonous documentation system that the software has become. The doctors have taken on additional tasks without additional personnel being hired to lighten the overall man-hours required to perform all of the tasks for individual patients. The scribes help with the doctor’s desire for more face to face time with their patients but again, defeat the original purpose of the software, to be more efficient than a paper system. Those without scribes were often taking on hours of work to do at home as they simply did not have time to complete their note-taking during regular office hours. While the system was meant to make lives easier for doctors, it often wasn’t.

Despite the results, the customer for the system is still the doctors. They’re the ones who are directly using the software as well as giving input to the developers for changes. Some may argue that it is the patients as the whole service of medical care is for them, but like Quickbooks is for accountants, Epic is for doctors.

The lessons from the implementation of this system apply to almost every industry. The man at the end of the article is a perfect example of this, as he was experiencing similar problems at his job as a construction supervisor. Many individuals are losing their direct interaction time aspects of their jobs to devote the time to using software in one way or another.

I’ve always thought of this battle between ease of use and complete functionality as a struggle that directly works in the world of security. People are always afraid of being hacked, or their information stolen but if the system is complicated, and has extra steps for users to ensure security, users want an easy way out. Whether it be simple passwords, or a lack of use of two-factor authentication, users often want the easiest means of use over the most secure means.
Link to the article here: https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers

From the blog CS@Worcester – The Road to Software Engineering by Stephen Burke and used with permission of the author. All other rights reserved by the author.

What I found interesting about the article on Why Doctors Hate Their Computers is the entire process or evolution of the software. The entire journey the doctors had to go through in order to accommodate the software that has begun to invade their profession. As with many different situations, being able to play around with something new that you haven’t used before is exciting. However, after a period of time has passed, you will notice how the change has affected your life. This is what has happened to the doctors that once praised the new software to hating it. Before software was introduced, all paper-based systems were balanced around human behavior. Such technology did not account for that and focused around efficiency. The downside to this is the difference in efficiency for computers did not translate one to one for efficiency in humans. Which lead to a decrease in efficiency for the lives of doctors world-wide who has come to depend on such systems. Due to this, doctors started hiring more workers in order to reduce the time loss and complications generated from using the software designed to “help” doctors to increase human efficiency again. This process is never ending as it continues to try and find a balance which is indeed interesting.

The reoccurring problem that causes the doctors lives to be harder than easier would be the data entry process. Asking questions and storing the answers require time, and time is limited per patient. By increasing the number of fields that doctors had to fill, reduces the load and helped other jobs elsewhere but reduces the time available to help patients and increased the workload for doctors.

The real customer for the system is not the doctors but those above the doctors who chose to believe that doctors would appreciate the system. By appealing to a certain client and not directly to those who are going to use it will definitely create an issue. However, once the system is in place, the doctors will have no say in whether they want to use the system or not. The amount of money spent on the new system must be used to get their money’s worth.

Also, the lessons from the implementations of this system also apply elsewhere as more and more people are gaining access to computers. As such they become dependent on software that could potentially improve their workflow. These situations are what is needed to continually improve software and tune them as needed to satisfy the customer’s needs. Software and humans are alike, as they are ever evolving and adapting to new situations thrown at them. The article is very relatable to how new software has effected society as a whole today and was a very interesting read.

From the blog CS@Worcester – Progression through Computer Science and Beyond… by Johnny To and used with permission of the author. All other rights reserved by the author.