A 2013 Research and Development (RAND) survey of medical practitioners found that many were unhappy with certain technologies they had to work with, in particular the Electronic Healthcare Record (EHR). While many acknowledged that technology does afford efficiency, they also questioned if it was worth having to tackle the confusing user interface and laborious entry of data.
Should patients and practitioners alike be wary of technology? Two examples of technology in healthcare allow us to weigh the arguments.
The EHRIn a world where data collection and processing is increasingly needed to be efficient and accessible, the area of medicine and healthcare is no exception. The EHR is an integral part of healthcare that allows doctors to look back at past patient records in order to make a more educated judgment and diagnosis.
One would expect this to speed the process up, yet that is not always the case. As evinced from the aforementioned RAND survey, practitioners have many complaints about the actual efficiency of the system, bemoaning that it is difficult to use with some even saying that a scribe might be able to do the job better.
In Singapore, the Ministry of Health also acknowledged flaws in the EHR and said that plans to improve it were underway, although the completion thereof could take many years.
How does all this affect healthcare negatively? For one, practitioners may end up being more transfixed on navigating the electronic record than paying attention to their patients. Physician and writer Abraham Verghese argued in a TED talk that the EHR strips away patient-centred care, opining that doctors are more concerned with what is on the screen than what is causing the patient discomfort.
Having to work with an unpleasant system daily does make for a frustrating working environment. And in extreme cases, patient waiting times might be prolonged due to glitches in the system.
However, above and beyond the technical flaws of the EHR, there is the danger that practitioners could be overly reliant on it; which obstructs independent thought. Being presented with the EHR every time a patient visits, doctors would tend to make a diagnosis based on what is in the patient’s EHR, possibly ignoring external circumstances.
The most infamous example of this is probably of ‘patient zero’ of the Ebola virus in the United States in which the doctor misdiagnosed the patient due to a ‘gap between nurse and physician workflows’ that was supposed to be mediated by the EHR, which failed to reveal that the patient had travelled from Liberia.
Besides the EHR, other forms of technology in healthcare have proven to possibly be detrimental as well. Robert M. Wachter, a prominent academic physician in the University of California, San Francisco (UCSF) once recounted that his hospital once gave a teenager a 39-fold antibiotic overdose due to a glitch in the prescription system that altered the units of the drug. While the boy survived, such an episode proves that technical errors are possible and even deadly. And if we are to trust technology to be an assistant in our life, then we must be ready for more of such episodes.
Internet prescriptionsInternet prescriptions are not something entirely new, given that search engines such as Google and medical forums such as Medhelp have existed for awhile now. But the sentiment that such avenues are ‘reliable’ and ‘acceptable’ is something that is relatively new.
Websites like WebMD allow people to input symptoms they face and accordingly, provide them with a list of possible problems. This is a harmless resource on its own, but may potentially become a hazard if people become too overly reliant on it, seeing it as a convenient oracle for them to derive remedies; a cheaper option compared to having to see a doctor.
The danger is intensified when people decide to purchase medicine online on their own to self-medicate. Such attempts are unsafe given that they do not have proper and professional knowledge in the area.
More recently, the controversial usage of telemedicine such as Amwell and Telehealth in healthcare has afforded doctors with the ability to treat and diagnose patients via secure video or phone. Such a process certainly opens a can of worms with regards to professionalism and accuracy of treatment. It begs the question of knowing when to draw the line with regards to visiting a doctor physically or virtually. Should people end up downplaying their symptoms, it would well be a case of havoc. MIMS
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