Dear CSS Members and Colleagues:
Are you a “techno-optimist” or a “techno-pessimist”? Atul Gwande, in the enclosed article considers the evolution of the electronic medical record (in this case EPIC), the overall impact of technology on healthcare, and physician burnout. The reality is that we are in the midst of an enormous socio-economic transformation of healthcare. As physicians, we are tasked with adopting new technologies which seemingly increase our work, challenge our enthusiasm, but promise better patient care coordination and treatment outcomes. Indeed, all technological innovation presents the initial barrier of adoption. Take for example, patient-specific planning (Blueprint® and other programs). This gives surgeons unprecedented control to consider “trial without error” (as proposed by Prof. Pascal Boileau), but adds work to our process of caring for patients. My own estimate is that it takes about 15 minutes per patient (uploading images, planning, selecting the plan, ordering guides, etc) to complete this process. While I feel gratified that I am giving my patient the best possible solution for their problem, I understand that the ultimate market success of any new technology is to reduce costs, reduce errors and improve efficiency. In fact, John Maeda from MIT Business School has written in his book “The Laws of Simplicity” about the market success of new technologies that accomplish this aim. So, as you read the article from Gwande, ask yourself how you might apply your efforts to improve the EMR and other new technology not only to help your patients but your own efficiencies and successes.
The next Codman Shoulder Society Meeting (Saturday, June 22nd, 2019) will consider some of these issues. An announcement regarding the preliminary program will be forthcoming. This year we’ll consider the importance of measuring outcomes and costs and the methods to do so. This will be based on lessons learned from Harvard Business School. The use of technology will make this easier in the future. We will also discuss disruptive innovation within large organizations, just as Gwande discusses in the enclosed article.
Jon JP Warner, MD