The AMDIS Connection | Always Connected vs. Overwhelmed: Where Do We Draw the Line?
The debate over whether a smartphone is a medical device is something of a moot point. Granted, there’s a lot of excitement and chatter about how docs are adopting smartphones, iPads, and the like, but in this discussion, one issue that has been largely overlooked is the information-overloaded environment that we work in now.
Smartphones are now as much computers as the most powerful computers were five years ago. The processor speed, the memory they contain, the detail displayable on their screens—the new generation of smartphones’ capabilities are amazing and are begging for the right niche.
There’s no shortage of companies seeking that right niche as well. Some are working not to cram an EMR into a smartphone, nor to replace pagers or cellphones, but to integrate the data environments in EHRs with communication capabilities, whether texting, cellular or VoIP.
As these companies aim at smartphone-enabled medicine, an acute sensitivity to information overload is just what the clinician needs. After all, how many pings can you take from your cellphone, SMS text, Twitter, Facebook, Buzz and the million other similar tools out there? Being so connected has become so overwhelming for some that a reaction is starting to happen—people are turning off one or more streams so they can have a moment’s peace.
Roaming the show floor at HIMSS and AMDIS, it was clear to me that the tools are available to leverage an entire EMR into a smartphone. But that’s a bad idea: It’s too much information. The required navigation, pull-down menus and drill-down of information display—never mind data entry—is still not a proper fit for the smartphone form factor.
At the other end of spectrum, I saw a company that was creating multiple alert sounds, so clinicians would know when something is urgent and when something is just acute and not urgent, and so on. But this also misses the point, saying, in effect, that humans really want to get every bit of information as soon as it appears, and that just by using a different sound, you’re going to make it easier for clinicians to tolerate this connected-always-and-everywhere environment.
What we don’t yet have is intelligence in our alerting and messaging environments, so that the right person, the right message and the message’s importance are all matched up consistently. You can’t solve this problem by creating a medical communication environment in a smart phone that uses a multitude of sounds. That approach will never solve the problem. These are early days in our understanding and appreciation of how complicated the signal processing of medical communication already is, and needs to be, in order to avoid deadening clinicians’ senses to the point where they tune out the background din, and possible miss a message that is literally life or death.
Smartphones’ ability to present so much data is wonderful, but it’s also a curse. We need to re-open the discussion about how sophisticated signal processing—all signal processing—will need to be before new tools can really be used for what we dream about, which is physician heads-up display, awareness, and compete command of inpatient and outpatient practice anywhere.