huh? if the records are "standard, digital and transferrable", it means all of the work associated with those records is sped up.
- Need to retrieve past doctor visits about a patient? person at front desk no longer needs to walk to the folder closet, then scan the whole thing to find your name and then read through all of the documents to find the relevant visits. just click a button.
- How about getting the prescriptions provided to you from a previous doctor? Reduction in time to phone / fax the previous doctor. just click a button.
- Want to check if your insurance covers your procedure? Receptionist calls the carrier, sits on a 6.5 minute customer service wait queue, then gets the info versus 1-click.
The problem is that you've optimized time savings for the cheapest people for a hospital to employ at the cost of time spent by the most expensive people a hospital employs, eliminating a handful of cheap jobs while making the expensive jobs both less efficient and happy.
It is more productive if the person just knows if the procedure is covered because the insurance companies have stable standards and trust the medical providers rather than having it all be JIT decisions based on rules that either constantly shift or are so vague/low trust as to be "you medical person yourself can't decide if this procedure is covered, you have to call us."
And back in the paper days, the staff would pull up the records for the days appointments. ER visits would have less data but normal medical care would be fine.
> if the person just knows if the procedure is covered because the insurance companies have stable standards and trust the medical providers rather than having it all be JIT decisions based on rules that either constantly shift or are so vague/low trust
None those are related to use or lack of use of technology. Those are purely bureaucratic rules setup by insurance carriers.
> And back in the paper days, the staff would pull up the records for the days appointments.
And sometimes those papers would get lost, or maybe they're still sitting in the folder on a door because someone forget to clean them up, or they were in the wrong order so it took the person longer to find the person's name, appointments would shift, etc. etc.
I can't believe I'm having to explain to someone the productivity advantages of a system of record to a technology focused crowd...
> None those are related to use or lack of use of technology. Those are purely bureaucratic rules setup by insurance carriers.
They are very much related to use of technology, because they are enabled by technology. The degree of bullshit paperwork every white-collar worker has to deal with nowadays is a direct consequence of computers making it possible to make us do that work, and for the recipients to process it.
The benefits of those processes are whatever they are designed to be, but this creates a false image of net productivity, because the costs are now hidden, smeared across everyone's workload, adding to a vague sense of dissatisfaction and low productivity. In contrast, if you tried the same processes few decades ago, it would mean hiring dedicated people on both ends, and the costs - as measured by their salaries - would be clearly visible.
> I can't believe I'm having to explain to someone the productivity advantages of a system of record to a technology focused crowd...
You don't have to. But you're missing the disadvantages of the situation when maintenance of that system of records becomes a job distributed across everyone. It's not the digital recording per se that's the problem, but the fact that everyone is now also their own secretary.
> The degree of bullshit paperwork every white-collar worker has to deal with nowadays is a direct consequence of computers making it possible to make us do that work, and for the recipients to process it.
These are bold claims backed up by little to no data other than your anecdotal observations. Productivity has generally been on a steady upward trend in the US since it was first measured in 1947. My own professional service business, which does require a decent amount of "bullshit paperwork" would not have been possible at the scale it achieved without technology.
> In contrast, if you tried the same processes few decades ago, it would mean hiring dedicated people on both ends, and the costs - as measured by their salaries - would be clearly visible.
Ever seen Mad Men? There was literally a full floor full of human beings typing out bullshit letters on typewriters because computers didn't exist in the era.
> Ever seen Mad Men? There was literally a full floor full of human beings typing out bullshit letters on typewriters because computers didn't exist in the era.
That's my point: those people received salaries for typing out those letters, making the cost of it clearly visible to the business.
So your point is "we visibly saw the cost before, but no longer see the cost now with tech. Therefore we can conclude that the invisible cost now outweighs the visible cost...because ummmm it's not longer visible?"
Part of the opioid crisis caused by basically bribing doctors
Yes I’m well aware that when drug abuse was happening in the “inner cities” where the government looked the other way because it was more concerned with propping up countries during the Cold War, the same people who want to treat drug addiction like a “disease” when it’s happening in “rural America”, it blamed “single mothers” and “lack of morals”.
That will only be a speed-up if the time saved from easier information retrieval is smaller than the time spent in increased paperwork, which it may or may not be, but is an assertion that needs justification.
In general, I'll note producing documentation is fairly slow and tedious. It takes something like an order of magnitude longer to write a sentence than to read it. So this optimization is only going to be a productivity boost if this paperwork is accessed repeatedly, dozens of times in the course of treatment (the productive thing).
> I'm beginning to think y'all are conflating the increase of documentation with the use of digitalization. The two aren't mutually exclusive.
I think what we're talking about is a clear (if non-typical) example of the Jevons paradox[0]. Digitalization makes creating and processing paperwork more efficient, allowing the overall organization as a system to support/afford more of it. As a result, amount of documentation and form filling increases.
Hilariously that wikipedia page mentions nothing about productivity. In fact an article that talks about Jevon's paradox says this:
According to the Ford Motor Company, its fuel economy ranged between thirteen and twenty-one miles per gallon. There are vehicles on the road today that do worse than that; have we really made so little progress in more than a hundred years? But focussing on miles per gallon is the wrong way to assess the environmental impact of cars. Far more revealing is to consider the productivity of driving. Today, in contrast to the early nineteen-hundreds, any American with a license can cheaply travel almost anywhere, in almost any weather, in extraordinary comfort; can drive for thousands of miles with no maintenance other than refuelling; can easily find gas, food, lodging, and just about anything else within a short distance of almost any road; and can order and eat meals without undoing a seat belt or turning off the ceiling-mounted DVD player.
A modern driver, in other words, gets vastly more benefit from a gallon of gasoline—makes far more economical use of fuel—than any Model T owner ever did. Yet motorists’ energy consumption has grown by mind-boggling amounts, and, as the productivity of driving has increased and the cost of getting around has fallen, the global market for cars has surged. (Two of the biggest road-building efforts in the history of the world are currently under way in India and China.) And developing small, inexpensive vehicles that get a hundred miles to the gallon would only exacerbate that trend. The problem with efficiency gains is that we inevitably reinvest them in additional consumption.[0]
In other words, you're too narrowly focusing on "miles per gallon", not the fact that "any American with a license can cheaply travel almost anywhere, in almost any weather, in extraordinary comfort; can drive for thousands of miles with no maintenance other than refuelling; can easily find gas, food, lodging, and just about anything else within a short distance of almost any road; and can order and eat meals without undoing a seat belt or turning off the ceiling-mounted DVD player."
For example, in the show Mad Men, you'd see a whole floor full of human beings who's sole job was to type out letters on typewriters. Now, those jobs are obsolete and the white collar worker is responsible for them. Still bullshit paperwork, but the white collar worker now has to do them.
The overall trend for productivity since it was tracked in 1947 has been on an upward trend with its sharpest 1H downward trend ever this past year. Are you seriously suggesting white collar workers magically got more bullshit paperwork just these past 2 quarters?
Is there a "standard" medical record, or does each system implement its own proprietary format? Are the records transferrable? If so, why am I asked to fill out a complete medical history form on paper every time I visit the a doctor, as if I'm a new patient, when all the doctors I see are in the same network and presumably use the same EHR system.
