> There is an illusion that technology automates work—instead it only changes it.
And a number of follow-up attacks on technology totally in the spirit of Jacques Ellul.
My wife is a physician, and through her and some of my personal experience of working with hospitals, this is how I understand the problem:
* Programmers who write EMR systems critically lack the knowledge of how hospitals or physicians operate. There are multiple causes to this: the process of writing such software isn't a grass-root movement. It's heavy design-first of large, well, huge systems before they are implemented by grunts who never have any idea about how the whole of the system is intended to operate or even how the tiny slice of it they work on is supposed to be used. I should know this, since I was one of those.
* Doctors despise programmers. Doctors also don't want to be programmers. To a typical doctor, a hospital's staff programmer is similar to a medical secretary: a hoop they need to jump to get their work done rather than an actual aid. Being a programmer, try advising a doctor to do something differently, even if that's about how they use their computer, and be exposed to an hour-long lecture on how they studied for N long years, and how their education was so much more intense than yours, and how they had to endure and so on. Of course, doctors see doing programming work as being beneath them.
So, what happens is that instead of interfaces that could enable doctors to be productive at using their computers, they get absolute garbage that's impossible to automate and requires arduous manual labor. I.e. if doctors wanted to learn how to use SQL to access their hospital database, and, let's say, were able to write some short scripts that automated patient processing, communication with other departments and so on, they'd be spending way less time in front of their systems. But they don't.
Instead they get MS-Windows-styled GUI garbage. Impossible to automate, with the source locked away from them, written by someone they couldn't bother to meet and chat with for an hour because their paycheck likely has an extra digit.
My wife being in radiology department reported that, eg. most times patients are sent to them, even inside the hospital for some imaging, they don't get their forms properly filled by the sending doctor. Not only the sending doctors don't know how to fill those forms correctly, they don't want to know. An incorrectly filled form will result in the radiologist calling them back, and they'll be able to communicate what they want done to the patient in this way. It's both because the forms are too inflexible, because there's no trust in the system, and, especially that even if the form is filled correctly the receiving end might not know how to process it correctly.
And this doesn't depend on the country. Countries with mostly uniform, long-standing healthcare systems suffer the same fate.
----
To me, it's clear that the change that needs to happen is that doctors need to become more like programmers. It's unfortunate that they need to spend so much time learning their trade, and it seems like on top of that they need to study something far divorced from the rest of their main subject, but I don't see any other way.
It's not about technology failing doctors, it's the doctors who don't want to embrace technology.