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U.S. workers have gotten less productive – no one is sure why

washingtonpost.com

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Re: U.S. workers have gotten less productive – no one is sure why

#331

Post by pdntspa »

Retric wrote: post #96
lkrubner wrote: post #88

I've read that doctors now spend as much as 50% of their time documenting their work. Companies such as Epic, which provide the software that hospitals use to build databases of patient data, have been big winners in the new world of hospitals-depending-on-software. But did the doctors become more productive? By almost any measure, they became less productive. People in tech keep thinking more tech will solve problem…

That documentation time is largely driven by the insurance industry which was really painful before these systems. It’s almost shocking how much more productive doctors are inside the VA.

I am seeing all this blah blah blah about how everything pins down to insurance.

But if medical pricing was such that insurance wasn't required, then patients would better audit their own care receipts and this fraud issue would eliminate itself, and as a side benefit we'd have sane pricing for medical care.

Re: U.S. workers have gotten less productive – no one is sure why

#332

Post by VLM »

pastaguy1 wrote: post #259
kps wrote: post #148

Earlier quoted context omitted.

> It’s almost shocking how much more productive doctors are inside the VA. Cerner has a contract to fix that.

What?

Cerner got $10B a couple years ago to prevent the VA system from working. Its happening per plan, so far.

Re: U.S. workers have gotten less productive – no one is sure why

#333

Post by theGnuMe »

lkrubner wrote: post #88

I've read that doctors now spend as much as 50% of their time documenting their work. Companies such as Epic, which provide the software that hospitals use to build databases of patient data, have been big winners in the new world of hospitals-depending-on-software. But did the doctors become more productive? By almost any measure, they became less productive. People in tech keep thinking more tech will solve problem…

Message passing was basically a solution for this in the tech world. Send messages to everyone and if they implement that message then they act.

Re: U.S. workers have gotten less productive – no one is sure why

#334

Post by StillBored »

mschuster91 wrote: post #299
StillBored wrote: post #242

Earlier quoted context omitted.

IMHO, this is because the people writting GUI's these days are mostly incompetent, or hamstrung by "web" technologies. Early GUI's didn't have the problem you describe because they were designed as discovery mechanisms to the underlying function. AKA, the idea was that after clicking File->Save a dozen times you would remember the keyboard accelerators displayed on the right hand side of the menu. Or if nothing else,…

> IMHO, this is because the people writting GUI's these days are mostly incompetent, or hamstrung by "web" technologies. The latter is definitely not the problem. Even the Twitter re-design from a couple years back still supports all the old hotkeys. All it takes to at least support a tab-based workflow is using the "tabindex" property if your form isn't logically laid out already, and the rest can be done by capturi…

Its not always just about tabindex. For example it might be about understanding that there are multiple ways to fill out a form that makes sense. Then hiding/showing pieces as needed and/or providing hotkeys to jump from field 1 to field 5 because the user doesn't want to fill out 2,3,4 because they are optional. Its about keystroke optimization. Sure they can press tab 3 times, or they can just press ctrl-5 (or whatever) to get there.

If you watch people use the sabre command line interface (the one from the 1970s?), you can see some of what i'm talking about when people are just filling out the forms with the submission line, its less using the GUI and more just knowing some sequence of keystrokes that results in an action being taken.

AKA its possible to do both, without having the user wear out the tab key, or grabbing the mouse all the time.

Re: U.S. workers have gotten less productive – no one is sure why

#335

Post by ivlad »

mschuster91 wrote: post #299
StillBored wrote: post #242

Earlier quoted context omitted.

IMHO, this is because the people writting GUI's these days are mostly incompetent, or hamstrung by "web" technologies. Early GUI's didn't have the problem you describe because they were designed as discovery mechanisms to the underlying function. AKA, the idea was that after clicking File->Save a dozen times you would remember the keyboard accelerators displayed on the right hand side of the menu. Or if nothing else,…

> IMHO, this is because the people writting GUI's these days are mostly incompetent, or hamstrung by "web" technologies. The latter is definitely not the problem. Even the Twitter re-design from a couple years back still supports all the old hotkeys. All it takes to at least support a tab-based workflow is using the "tabindex" property if your form isn't logically laid out already, and the rest can be done by capturi…

It is a problem because with TUI keyboard is the first-class input device whereas with GUI and especially HTML it an afterthought most of times. Yes, there are exceptions like Twitter and Gmail and then there are millions other interfaces where mouse is the only way to navigate.

Re: U.S. workers have gotten less productive – no one is sure why

#336

Post by pixl97 »

scruple wrote: post #68
BaseballPhysics wrote: post #66

Earlier quoted context omitted.

Assuming that's true--and I'm not sure it is--mass retirement of baby boomers, which has already begun due to forced retirement during the pandemic, is going to absolutely decimate the labour supply, which has enormous knock-on effects (including a rise in inflation).

You can go back to the year 2000 and find Fox News and CNN talking heads warning us about the impending doom of baby boomers retiring and taking the economy with them. Any year now... What has actually transpired in the meantime has been record breaking bailouts, corporate handouts, and profits, while workers pay remains in stagnation and housing market inflation goes through the roof (because of slow development, IM…

Any year now started in 2020.

https://www.pewresearch.org/fact-tank/2021/11/04/amid-the-pa...

Re: U.S. workers have gotten less productive – no one is sure why

#337

Post by lotsofpulp »

conductr wrote: post #282
sokoloff wrote: post #193

Earlier quoted context omitted.

This is amusing as, 10 years ago, my wife (a decade-plus under 60, even now) showed up to a consultation with a doctor who remarked that she looked very good for someone over 60 and who suffered from a series of conditions that she did not have but showed up in "her" medical records.

My wife is in 30s but has had a lot of women's health stuff going on the last decade. We stay completely within the same "healthcare network" of hospitals precisely because they actually use the same system and all doctors can access it (obviously we like the providers as well!) But even for basic procedures we could save a little on like lab work or imaging by going out of this network we've learned it doesn't reall…

We do the same. My wife sees tons of suboptimal healthcare delivery due to lack of doctors having the necessary information. In our current area, it is easy to find doctors they use mychart and interface with local hospital, so if we were to end up in the hospital, our medical history is immediately available.

Re: U.S. workers have gotten less productive – no one is sure why

#338

Post by ddoolin »

StillBored wrote: post #242
conductr wrote: post #110

Earlier quoted context omitted.

I don’t think productivity was ever the goal of this software. It was to have a record that is standard, digital, transferable, etc. Doctors fought it as long as they could because they knew what it meant for them. I remember pretty early demos in early/mid 2000s when I was doing some clinical grunt work in college. I had written some software to make my department’s life easier so I was offered up as the hospital’s…

IMHO, this is because the people writting GUI's these days are mostly incompetent, or hamstrung by "web" technologies. Early GUI's didn't have the problem you describe because they were designed as discovery mechanisms to the underlying function. AKA, the idea was that after clicking File->Save a dozen times you would remember the keyboard accelerators displayed on the right hand side of the menu. Or if nothing else,…

I agree with you. Although I don't think it's incompetence so much as laziness. Not just "too lazy to make a good UI" but "too lazy to find out what makes a UI good." I've seen so many coworkers happy to slap some basic form together and expect that to be good enough.

I'm constantly writing UI for sports teams who do not at all like to waste time with these kind of fiddly UI elements and flows. Most of them would likely stick to Excel if our solutions are more cumbersome (which is a high bar to meet/beat, but rightfully so). They need to be able to easily get to data and relevant, connected pieces of data, quickly enter data into relatively complex forms, and have it all be clear, reliable, and fault-tolerant. This means making some tradeoffs, particularly around what is considered modern UI aesthetics, and doing things most UI developers don't need to do such as automating little things, adding hotkeys, etc.

Re: U.S. workers have gotten less productive – no one is sure why

#339

Post by danjoredd »

Mordisquitos wrote: post #144
lkrubner wrote: post #88

I've read that doctors now spend as much as 50% of their time documenting their work. Companies such as Epic, which provide the software that hospitals use to build databases of patient data, have been big winners in the new world of hospitals-depending-on-software. But did the doctors become more productive? By almost any measure, they became less productive. People in tech keep thinking more tech will solve problem…

> People in tech keep thinking more tech will solve problems and they keep underestimating the flexibility of the old models. Related to this, but in a completely different context, I have had similar thoughts lately when eating out at restaurants in Spain. It's incredibly frustrating from a customer's point of view when the waiter taking your group's order has to use a newfangled tablet or phone-like device and tap…

What upsets me are those dumb QR Code menus. Battery dead? Out of service? No food for you amigo.

Re: U.S. workers have gotten less productive – no one is sure why

#340

Post by robertlagrant »

nradov wrote: post #201
yamtaddle wrote: post #165

Earlier quoted context omitted.

If so, that's hilarious, because that's precisely one of the jobs all these expensive, painful-to-use computer systems were supposed to replace. You'd take a year or two course at junior college, to learn shorthand and drill some medical terminology so you'd be less likely to make a bunch of simple transcription mistakes, then go to work.

There's still a fairly large job market for medical transcriptionists, but that's a different job than being a medical scribe. Transcriptionists don't use shorthand any more, they mostly work from digital voice recordings. And they're typically not transcribing from scratch; now usually a voice recognition system does the first pass and then the human edits it to fix the ~2% errors. Transcriptionists don't usually wo…

Microsoft recently bought Nuance for this very reason.
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