Thursday, October 6, 2011

Steve Jobs - What if he had taken on the HIT challenge?

Yesterday, I saw something that made me think of the difference between a "techy" and a "regular" doctor's approach to technology.
We were installing an upgrade to a popular medical dictation software.  The upgrade was over the network and was to occur seamlessly overnight.
Unfortunately, in the morning when providers logged in, they saw a big message in the middle of their screens saying the software would now be installed and during this process, they would not be able to use various software including MS Outlook.
To make matters worse, this was a long install process and the message would stay on top of all other windows.

When the IT person was told about the problem the response was,
"What's the big deal?  Just drag the message window down so it does not interfere with other windows, and use web Outlook.  What if you can't dictate you notes for a while?  Just use the keyboard!"
I am sure a number of docs had figured that out and went about their work.  But many were complaining...

The world is made up of 2 kinds of people (simplistic view with lots of assumptions):

  1. Those who love Linux because it is open and they can tinker with it and troubleshoot it and they get a thrill out of making a difficult thing work.  Some of these same people would prefer a PC over a Mac because of similar reasons.  They love messing with the hardware and drivers and they know how not to get viruses.  They would hate a device where they cannot modify the OS or hardware!
    I would venture to suggest that these same people may also get a kick out of fixing their furnace and replacing a faucet.
    These might also be the folks in the IT industry.
  2. Those who want to take a device out of the box and just have it work.  They want to use the device to do what it is bought for without worrying about trouble shooting the device.

Fixing things and finding workarounds is fun and gives the person satisfaction from having solved a tough problem.  But when time is short, when there is important work to be done, when the interface creates inefficiencies, it causes a lot of frustration.  Having worked on both sides of the fence (Clinical and IT) it is quite obvious that the 2 sides don't speak the same language, are clearly not on the same page.  Our current EHR systems are a classic example.

Physicians probably don't know what exactly they want but they know what they have is not ideal.  They want someone to figure out what their needs are and create something simple that works that actually helps them take better care of their patients in less time.

I really wonder if Steve Jobs ever got to see one of these EHR interfaces and work-flows, saw the chaos of a clinician's day, the frustrations, the inefficiencies, ....
An iPad is arguably the best media consumption device ever made.  EHRs have a ton of data, and docs need a device with the right form factor and data visualization to consume information about their patients as they walk from room to room.

Would he have taken on the challenge to fix it?  Would he have made a difference in people's lives by improving care via better HIT products?  Did we lose a huge opportunity in his untimely death?


  1. Just read your post on KevinMD, agree social media can be intimidating to some MD's, but I have found many are simply unaware of the utility in medicine and physician communication. I think if somehow we could raise awareness of the benefits for the medical community it would help get more physicians on board. Thanks for the post!

  2. (the social media anxiety disorder post is at
    @Doctor Mom,
    This is a bit like deja vu. I remember in 1994-95 struggling to help physicians see the benefits of the WWW.
    Use cases of Social Media that help solve medical education challenges that are presented at live conference and in print media will help us reach the tipping point in the medical community.