As an employee, when you work with a computer in any capacity, you have agreed to all of your computer activity is being monitored.
In theory, this is both reasonable and legal. It’s the corporation’s hardware and software and you should only use it as part of your job. It’s not there for your amusement, and I think most of us can agree that it’s OK for an employer to monitor our online activity—while at work using their equipment and network— if for no other reason than to protect themselves from malicious software attacks which can damage both their business and, more importantly, their patients well being.
However, what does this corporate monitoring of physician’s computer activity mean in practice?
Well, in practice, it means every keystroke is fair game for capture.
Consider this. I once saw my typing rate in words/minute, graphed on a bell-shaped curve compared along with all my other physician colleagues—data which had been extracted to help evaluate my electronic health record (EHR) efficiency. (FYI, I was in the top quartile!)
Think about that for a moment.
When I am clicking or typing within a patient’s EHR, I am generally trying to get a handle on the patient—how sick is this patient, do they need to be admitted, do I need to transport them, could there be something else going on, how should I communicate this information for a f/u physician, etc.
EHR engagement for a physician is a high-level cognitive activity, sometimes with life and death implications. The last thing I am concerned about is my typing rate.
However, I recognized that at some level within a healthcare corporate entity, the physician-EHR dyad is simply another data source, one to be extracted, analyzed, compared, and made more efficient.
It was at that moment I recognized the greatest flaw in EHR technology.
It’s not problems with the user interface, or data compatibility, or HIPPA; it’s that the EHR —and the IT system it is connected to—has an unquenchable thirst for data, something which is dehumanizing to both the physician and the patient.
Anyway, this ‘digital dehumanization” isn’t something that is going to improve. If anything, with the increased focus on AI which has an ever-increasing voracious appetite for data in all forms, it is going to get much worse.
The only question for physicians (and patients) is this: Is it worth it?