Subject: What does the latest travel news tell us about health care analytics?
I’m excited to be seeing you soon at the INFORMS Healthcare conference. It’s amazing that this specialized conference, offered for the first time, features 13-14 parallel tracks. Congratulations to the organizing committee for putting together such a rich schedule.
As part of my preparations for leaving, I was looking over the latest travel news and noticed that a computer glitch at United Airlines had led to the stranding of thousands of passengers. The problem seems to have hit both United’s reservation and flight scheduling systems (“our computers are just paperweights” said one customer service agent).
Despite such occasional problems, there is no doubt that computerized reservation and scheduling systems have been a boon to the airlines – leading to more efficient airplane utilization and lucrative revenue management. But centralized computer systems can be fragile, and a focus on analysis may sometimes lead firms to deemphasize customer service (e.g., see Guillaume Roels’ blog post from INFORMS Austin).
A similar trade-off may be appearing right now, as hundreds of hospitals implement electronic medical record (EMR) systems. These systems may lead to both lower costs and improved quality – in part, because they would allow us to apply the sort of analytics that we hold so dear (there will be many talks on this subject at the conference). But there is the chance that these systems may be more fragile, on the whole, than paper records. And electronic systems may reduce the human contact that can be vital in services. For example, at our local hospital, implementation of EMR meant that physicians no longer hand their prescriptions directly to nurses but instead enter them into the EMR, to be processed later. This eliminates an opportunity for instantaneous error-checking and feedback between the nurse and the MD.
In general, as we develop our models and tools, we might be on the lookout for such unintended consequences. Have you noticed, or worried about, similar issues? Please feel free to comment, below.
See you soon,
-Rob Shumsky
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I’m really glad you brought this up. Such unintended consequences are, in fact, my biggest worry about EMRs. It is critical that an understanding of the systems/processes and how people in the systems do their jobs drive the analytics and EMR development process and not the other way around. There have already been documented EMR implementation failures because their designs did not sufficiently consider the workflows of all their users (physicians from different specialties, nurses, pharmacists, administrators, clerks, etc.). Everyone in the healthcare system is likely to use these electronic systems differently, and this has strong implications for what data you can collect, how you collect it, etc.
Alicia – thanks for the feedback. Yes, Dartmouth-Hitchcock Hospital has also been struggling with the mis-match between workflows and its new EMR. Understanding how work is actually done is crucial for developing a good system.