The Hospital: Where paper—not tech—still rules

My mother is home at last after a week in the hospital recovering from major surgery. I’m glad she’s at last on the mend, but I was struck by how tech-free her whole recovery experience has been so far. From the time she checked into the hospital a week and a bit ago until I visited her back at home for the first time, I was struck by how gadget-free the whole experience had been.

Here are some of the reasons why I think the hospital is one of those places where paper might reign supreme, even years into the future:

1. Some devices don’t work in the hospital.

For safety reasons, there are some areas in hospitals where you aren’t permitted to use mobile devices. And there are other areas where you are, but you can’t get a wireless signal due to the location (i.e., basements, elevators) or interference from the machinery of the hospital.

I also ran up against some odd firewalls when I tried to connect my iPad to the visitor network so I could FaceTime with my sister. There was no problem hooking in, checking email, even using video and other high-usage stuff, but as soon as I tried to log into Google Docs, it booted me out for porn concerns.

I was briefly flummoxed as to the logic there—FaceTime is fine, but Google Docs is dangerous? Then my Beloved, who has spent time in hospitals, explained to me that cloud storage is tricky because they don’t know what you’re putting there, and they’re liable if you use their network to access anything fishy.

2. Devices are expensive, and hospital rooms are notoriously unsecured.

I visited my mother for an average of twenty minutes each day she was there, and I never saw less than four hospital employees on any visit. Nurses, doctors, med students, meal delivery people, cleaners. People were going in and out, all the time. I asked my mother if she wanted to bring anything with her, and she said they were told not to bring anything that could “go walking.” So she left all the gadgets at home. The only device I saw was my stepfather’s iPhone, which of course went home with him when he left each night after visiting hours.

3. Sick people have lower attention spans, and so they read different things.

My mother, normally a decent reader, just couldn’t handle anything long or complicated. When I was at her apartment today, I saw a large stack of glossy magazines of the type she would never otherwise read otherwise. Yes, she technically could have read Zinio magazines on her iPad, but when you combine a short attention span with an unsecured room where things could “go walking,” I can see how you’d opt to run down to the gift shop with $20 and pick up some tabloids instead.

4. People like to bring stuff: wrapped, tangible stuff.

Yes, I could’ve brought my laptop, and loaded some e-books onto her Kobo. But she was sick. She needed cheering up. Judging from the stack of books and magazines beside her couch, her many visitors were succumbing to the urge to gift, and bringing her piles and piles of paper. She’ll have enough to read for a year!

Of course, a gadget person like me might not bring her a book or a magazine, but rest assured I did not show up empty-handed. It was flowers and wine for Mom from this gadget girl!

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I guess the takeaway here is that—as I’ve been saying from my earliest days with TeleRead—it’s flawed to assume that in the book game, there is a zero-sum, either/or ‘winner’ between paper and pixel.

There are times when e-books are clearly the more convenient choice: apartment-dwelling, traveling, building a library that you can cross-reference, annotate and so on. But there are also times when paper is a better option. And I think I found one this week.

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6 Comments on The Hospital: Where paper—not tech—still rules

  1. If forget the specifics, but as the feds have pushed for hospitals to go totally digital with their billing, it’s turning out that it is very easy to engage in digital fraud. It’s easier to automate creating bogus charges because behind those charges there’s no paper trail.

    For instance, when I worked in a hospital years ago, the starting point for charging for materials used was a sheet of paper at the foot of each patient’s bed. As something was used, a sticker would be placed on the sheet. Forging a sheet like that would be difficult.

    Go all digital, and there’s no paper at the end of the bed, no stickers, nothing substantial. One clever script can write all the digital data and it looks real. It can even be randomly assigned to multiple patients, making tracing difficult. Tack on a few extra, minor charges to each of a hospital’s hundreds of patients could be quite a windfall. And who’d know to challenge an extra charge for a butterfly needle when an IV is started?

    Where automation does make sense is for things such as tracking drug orders, checking for too-high doses and conflicts between different drugs.

    Long-term record keeping also makes less sense than the bureaucrats assume. I can tell a physician what matters about my lifetime medical history in about thirty seconds. Trying to digitize and combine medical records from multiple physicians across several states and two countries would be hideously costly and wouldn’t have any benefit. And the thousands of categories those bureaucrats want to classify diseases means a lot of extra expense for no benefit. There’s no real value in knowing which bones in which arm were broken in 8-year-old boys last year. Boys will be boys and will always be climbing trees.

  2. I was in the hospital for four days earlier this year, and EVERYTHING was digital from the scans of my plastic bracelet id before anyone did anything to me to the nurses and doctors’ notes.

    I’d say that your hospital is behind the times rather than an example of how all hospitals operate.

  3. Off topic, much? What about discussing what the writer was actually addressing: what form of READING MATERIAL works better for PATIENTS: ebooks or paper?

    Here, let me show you what staying on topic looks like. I’d be interested to know how many people do end up using their e-ink readers in the hospital – a Kindle is lighter than even many paperbacks and easier to hold – plus you can make the font size bigger. I’d imagine backlit tablets are less optimal though.

  4. I for one would definitely fight for using an e-ink reader in the hospital. I need the font adjustment. While I can read most magazine print under a strong light directly on the page, that is not the setup you encounter in a hospital. So I guess I would bring the cheapest of my Kindles which can be replaced for $69. Also would like to smuggle in my iPod Touch for communicating. Not cheap but cheaper to replace than my phone and I’m thinking I could maybe keep it hidden in plain sight in a glasses case.

  5. Michael,

    As a physician I wanted to say I disagree with your view on electronic medical records. While YOU might be able to tell me in 30 seconds what’s important in your medical record, can you do that after a motor vehicle accident with head injury, or intubated and on a ventilator? How about an 80 year old woman with Congestive heart failure and COPD who presents with fever after starting chemotherapy for ovarian cancer? Most elderly patients I see don’t even know what medications they take much less what procedures they have had done or if they have had an MI, etc. Having fast access to complete medical records not only expedites medical care- it is life saving.

    As for knowing which arm was broken, consider this: if that young boy presents with arm pain and x-ray shows a boney deformity it is extremely important to know if or which arm was broken. Otherwise he will need a biopsy to rule out some type of a cancer such as a sarcoma.

  6. I’m with Marilynn in wondering if your hospital is behind the times. I broke an ankle more than 5 years ago and every time a nurse came near me she was punching things into a digital device she carried, scanning something, etc.

    As to an ereader at the hospital – it’s one of the few places I wouldn’t take my Kindle but would find a paper book to take. The only time I ever lost a book was a time in the hospital when I had surgery. I was just too groggy and worried about other things to keep track of the book and make sure it came home with me.

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