Meditrol and Tricorders: A tale of two medical innovations

By: Raymon, Sasaki, and Morgan

As healthcare becomes more information-centric, technology and medicine start to converge. “IT, Gender, and Professional Practice” illustrates an example of using technology to streamline practice and make workflows more efficient and outcomes more accurate. However, the technology was imposed on major stakeholders, such as nurses and pharmacists, without their inputs for its design. Without an insight into their nuanced workflows, the system failed to adapt to the flexibility of nurses’ and pharmacists’ processes and instead forced them to conform to arbitrary standards.

Other aspects of the healthcare field are also being transformed by new technologies. “The Dream of the Medical Tricorder” describes the realization of a technology that was deemed impossible just a few decades ago. Medical tricorders are hand-held, computerized, self-service diagnostic tools that encourage patients to take a more active role in their health while reducing the burden on healthcare professionals. Relegating the mundane task (of information collection) to patients does not deskill doctors, but rather raises the level of clinical practice, an argument that was also brought forward in “Gender”.

As our population gets older, there will be higher demands on the healthcare system. The Association of American Medical Colleges projects that America could have “90,000 doctors fewer than it needs by 2020”, which signals a need for a more efficient system. Tricorders could mitigate this shortage by performing time-intensive but mundane actions, freeing doctors to perform higher value tasks.

On the other hand, the aging population tasked with using this new device might be fearful of computer technology. This was evident in the group of nurses studied in “Gender”–50 percent were 40 years or older and only 9 percent reported their computer skills as very good or excellent. This affirms the general notion that an older population is less likely to adopt new technology as a younger population. As the case study showed, however, more system flexibility and autonomy for users alleviates this fear.

In addition, if the technology does get adopted, it will lead to a change in boundaries among the stakeholders. “Gender” made clear that development of systems without considerations for the needs of all stakeholders can result in a “blame game” when things go awry, e.g. nurses and pharmacists exchanged blame when Meditrol did not perform as expected. This conflict was not expected by the patient care managers who designed the Meditrol implementation.

With this in mind, advocates of tricorders must temper their expectations with the nuances of current healthcare practices. For example, doctors may be unwilling to bring in patient-sourced information in their diagnosis due to fear of liability; in this case, doctors would verify the information again, which leads to redundancy rather than efficiency. Similarly, the nurses in the study verified each dosage doled out by Meditrol, since they didn’t trust the technology nor the pharmacist who were initially responsible for drug orders.

The introduction of information systems will not succeed if they conflict with existing tasks and organization structure. The use of medical tricorders can have a significant impact on the healthcare industry. However, introducing the technology is not enough; users do have the power to reject the technology if it lacks the flexibility to accommodate their needs. The makers or tricorder-like devices can learn from “IT, Gender, and Professional Practice” to avoid the pitfalls when creating technologies that are used by heterogeneous users.

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