Technology and automation have revolutionized the world. Technology and automation also have enabled some very bad habits that can have nasty consequences.
A captain with a major US airline once told me that the Airbus jet he flies, is one of the most automated, technologically advanced airplanes in the sky. He added, however, that there was a downside to that level of sophistication. “It makes a bad pilot average. It makes a great pilot average.”
Years earlier, a General Motors CEO spent heavily on automated technology in the form of robots to assemble cars in hopes of reducing the power of his nemesis, the United Auto Workers Union and to enhance quality. He solved neither and the financial consequences for GM were disastrous.
I believe we can find some parallels in healthcare.
When you depend so much on technology – whether it is the Cadillac of the electronic health record systems, the latest patient monitoring devices or state-of-the-art computerized diagnostics, all with hot and cold running automation, there is no guarantee this technology will improve quality of care or enhance patient safety.
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At the end of the day, healthcare is, and always will be, an industry that depends heavily on the skills, judgment and deep commitment from those who take care of patients. For those who choose this profession, like the airline captain, it must be more than just a job to pay the bills. Mistakes can have massively serious consequences.
During a recruiting trip to Manila, The Republic of the Philippines in 1992, I interviewed a very bright and passionate registered nurse. She had just completed a 12-hour shift in a 12-bed intensive care unit at one of the nation’s largest public hospitals. This facility lacked most of the modern technological equipment that American care givers have long come to rely on. She and four patient care technicians – she said she was the only nurse in the unit – had to manually check vital signs, manually monitor pressures and other requirements for care. She looked forward to moving to the US where she would earn five times more money so that she could support her family in Manila, and she was excited about having access to the latest technology and equipment, including basic things like hygienic molded doors to lower the chance of infection in the intensive care unit, which she had read about in nursing school. But she was also concerned that with all that technology, her nursing skills would suffer.
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Whether her concerns are accurate or justified, or not, it made me think about the state of healthcare and the proliferation of technology – our version of the global arms war – where organizations spend millions upon millions of dollars to have the latest and the best equipment. Yes, they spend it for the patients, but they also want to beat the competitor hospital down the street. It begs the question, is it making our care better, and safer?
We have the highest healthcare costs of any industrialized nation but we have significant problems with quality and patient safety and our life expectancy is less than those nations who spend so much less.
Depending on technology without a passionate commitment to quality and safety – to make the care of the patients a personal commitment – will not solve our growing cost and value problem.
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