“If you’re a young doc, you’re pretty used to (computers) in everything you do,” he said. “If you’re a doc who has worked off of paper, you’re 60 years old in private practice, you come into our organization, you’re trying to navigate complex electronic patient records, I think that you will be challenged to see the value of that. It’ll be a couple of years for it to mature.”
Dr. Joseph Kvedar, the director of the Center for Connected Health at Partners HealthCare, Boston, gave a bit more nuanced look at the software/doctor divide, noting it’s not so much about age as about the art of medicine.
“Almost all the clinicians who are in their most productive years in the workforce today are people who were trained in an era where it was all about the art” of medicine, he said, with less emphasis on structure, routine and quality metrics.
“Today’s medical students, today’s nursing students, they’re much more comfortable with the notion that it’s going to be guideline-driven care and it’s the exception to the guideline, rather than everyone’s an individual and the guideline’s an exception,” he notes, arguing that there will be more homogeneity in care going forward.
He sees conflicts continuing. “When you start to introduce automation into … environments, you find people pushing back. They’re worried about job security. And they’re worried about being automated out of a job,” he says.
Kvedar argues for “thoughtfulness” in applying the solutions, saying that automated technology can shoulder burdens providers aren’t interested in anyway. That leads to two benefits, he argues.
First, providers can cover more patients. “Our vision is that primary-care doctors, nurses—the folks in the patient-centered medical home—should be spreading themselves across larger” groups of patients, he says.
Second, providers won’t feel “overwhelmed” and will have a “reasonable work experience,” meaning that well-used clinical decision support has the capability of increasing productivity and improving the work experience.
Such focus on improving the work experiences of providers through technology has been high on many people’s minds. In an interview promoting a conference on “Humanizing healthcare technology,” Dr. William Maples, the chief quality officer at Mission Health, Asheville, N.C., noted that “burnout” is a huge problem: “We clearly have a workforce that is stressed,” he writes.
But, he said, it’s possible the technology can take over simpler tasks and “create a sense of joy, a sense of worth, a sense of value for our caregivers to execute an incredibly difficult job.”
Some suggest the conflict between providers and algorithms is best not avoided. Dr. Michael Kolodziej, the national medical director for oncology solutions at Aetna, said during the Health Datapalooza conference that oftentimes the “masterful physician is not so masterful,” and that the interventions of a clinical decision-support system—however annoying—are a useful check.
During an interview, he elaborated, “Doctors should embrace what they’re good at—which is interacting with patients. They should embrace the ability to approach complicated problems, respect the evidence base that’s out there, and come up with a plan based on that.” He concluded, “And be measured on their performance,” too.
Follow Darius Tahir on Twitter: @dariustahir