I've written in previous columns that I believe we need to find ways to reconcile the concepts of "patient" and "consumer" in healthcare. We live in an age of ubiquitous handheld devices and social media. Convenience is prized more than ever. In healthcare, patient and family expectations are evolving and we need to respond. Our response must include addressing the "suffering" that the healthcare system itself can inflict on patients — paperwork, waits and lack of coordination. We must provide genuine caring, but also address inconvenience, barriers and burdens.
Recently, I was struck by an article titled, "What We Lose By Hiring Someone to Pick Our Avocados For Us" by Gina Belafonte in the New York Times. She talks about some of the potential nefarious impacts of a convenience-oriented economy, including increased income inequality and loss of connection as we increasingly live inside our devices. She highlights the isolating influences of technology and how the "order-online-and-have-it-delivered" culture is taking something away from us — running into neighbors at the coffee shop or grocery store, for example. This paragraph from her article particularly struck me when thinking about our work in healthcare:
"Sociologists, beginning perhaps most prominently with Ray Oldenburg in the 1980s, in his book, 'The Great Good Place,' have analyzed the importance of the 'third place' in the urban world. Home is the first place, and work is the second place. But it is this additional realm, he argues, of informal sociality, that is so crucial to the maintenance of civic engagement and just civility."
Hospitals, clinics and treatment centers are definitely a crucial "third place." Our organizations are often anchors in our communities. Places where healthcare is provided should be places where we engage each other, nurture community and both give and receive civility. In the inevitable progression of technology integration, we must maintain healthcare as a foundational third place — even when that space may sometimes be virtual.
Technology should connect us, not further isolate us, especially in the vulnerable moments at the heart of our work. Even though we should respond to legitimate demands for convenience and greater accessibility, we must deploy technology that brings us together with empathy and respect.
It's also critical to recognize that healthcare organizations are also a "second place" in Oldenburg's construct. In my organization alone, we employ over 40,000 people. Our teams are telling us the same things as our patients. As we deploy technology, they are asking for greater integration as well. They want automation that brings efficiency, but also an opportunity to spend more time at the bedside or face to face with patients in the exam room. They are seeking ways to be more connected with each other so they can move through their days. Our team members crave respect, civility and connection as much as our patients.
This is a tall order. Our society is grappling with these issues. Healthcare is too. And, these issues are amplified further in New York City where I live and work. Our patients and staff are among the most digitally savvy of any community in America. The compactness and intensity that makes our city and hospital vibrant also drives stronger desires for convenience, accessibility and connection.
As an industry, we remain far from the integration that our patients and staff want. But, it must be our goal. We need to use technology to improve our outcomes and address administrative burden and suffering. So, as we integrate technology and AI into our system, we should be asking these fundamental questions:
- Will this technology reduce burden for our patients and our staff?
- Will it create space and time to allow us to connect at key moments?
- Will it help us to reduce disparity and expand access?
- Is the technology free of bias?
- How can this technology help us preserve humanity in healthcare?
I know these are lofty questions. And, we can't be naïve about the need for documentation and safety. But, at its core, healthcare is an enterprise of people taking care of people. Our challenge is harnessing the benefits of technology while maintaining our organizations as both "second" and "third places" for all who come to us for care and for all who come to work through our doors each day.