5 reasons doctors are good at technology
Diffusion-of-innovation is different in medicine and technology is often stalled in translation but doctors are still good innovators, here’s why…
We all play a role in the development of good technology, here’s why traditionally technophobic physicians might be contributing more than you think!
#1: Everyone is doing their best to keep up with technology
Everyone alive today is dealing with rapid, sustained, and sometimes frightening changes when it comes to technology.
- 1985 — ~1000 computers with constant internet connections
- 1994 — personal computers begin proliferating
- 2011 — ~8.7 billion devices with constant internet connections
- 2016 — ~3.7 billion users with connected devices
If we are honest with ourselves about the scale of the change we are collectively experiencing, it becomes a bit easier to be kind about how any particular individual chooses to muddle through their technological lives.
#2: Doctors are pragmatists
From the most influential thought leader, to the grouchiest technophobe the everyday response to a new technology determines its survival.
We’ve previously talked about “diffusion of innovation” theory.
- The population is assembled along a bell curve according to their willingness to deal with technological glitches (techies → visionaries → pragmatists → conservatives → skeptics).
- Technologies penetrates this bell-curve in accordance with its utility and reliability.
- The “chasm” is the gap between when something is first discovered by the early market(techies and visionaries), and when it becomes useful to the late market (pragmatists, conservatives and skeptics).
- “High-tech” refers to products that have not yet “crossed the chasm”.
- “Agile development” groups intentionally move them across the chasm.
Doctors are trained to be pragmatists. Simply knowing how the pragmatist role functions in the wider context of technological development can do a lot to defuse clinical tensions about the adoption of new medical tech.
#3: Doctors actively help medical technologies across the chasm
As an industry, medicine is generally conservative when it comes to technology. Regardless of personal inclination, doctors fill a gatekeeping role, imposing rigorous standards of evidence on themselves and others who propose changes to patient care.
So the technology adoption life-cycle in medicine looks a bit skewed with an elongated chasm…
Historically this extended medical “chasm” can lead to long delays in adopting medical tech.
- Penicillin was first reported in a 1929 publication by Sir Alexander Fleming, but it took 14 years before the first ten cases were treated in 1942 and production was not scaled until 1943 when the US army pushed it to coincide with the D-Day invasion of Europe.
- Handwashing for medical hygiene is attributed Ignaz Semmelweis in 1846 but it did not achieve widespread promotion until 90 years later when the first national guidelines were published by the CDC in the 1980’s.
Doctors work hard to shorten this delay in a safe, unbiased manner for their patients. In the medical context an agile development group might be called “bench-to-bedside” or “translational” research.
Usually a bench researcher will fill the professional “visionary role, and a clinician will fill the professional “pragmatist” role.
#4: Doctors bring up legitimate concerns with technology
While no one likes unnecessary delays, the chasm also fills an essential role of refining technology.
Electronic Medical Records (EMR) were prematurely legislated across the chasm, for instance with the 2009 US HITECH Act which affected institutions first.
While this action has speeded EMR adoption, it skipped the critical development techniques of agile development groups (i.e. minimum viable products, and niche-markets of initial consumers) which tend to refine software more effectively than enterprise developers can achieve.
EMR has led to a lot of frustration for pragmatist doctors who feel intuitively that the technology was not adequately vetted but often don’t know how to articulate their concerns.
One solution to this problem is a dual system, where traditional legacy frameworks are coupled with free-market app-like interfaces. The 2011 SMART platform proposed by the Harvard Interoperability Standard is an early example.
Secure clinical apps that run on iphones are another dual system that is currently running in hospitals.
#5: We need doctors to engage with high-tech offerings
As a physician, it’s a relief to realize that whatever opinion you have about technology comprises a valid contribution to its development.
As we’ve mentioned previously, the chasm is shortened when a pragmatist is willing to explain to a visionary what limits their adoption of a new technology.
Doctors are usually unbiased voices in this discussion, which makes them crucial to developing technology that works for patients.
In conclusion
Doctors are great at technological development and should be enabled to contribute an unbiased voice on the utility of the technologies they use.
NOTE: For better or worse, most tech diffuses through high-income populations first because of cost, although there has been a recent movement to design high-tech for low-income medical populations.
Reprinted with permission from ShareSmart.
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