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This seems like a caricature or an exception. Doctors are very aware of HIPAA (and the equivalent in every other country), and the professional and monetary cos

This seems like a caricature or an exception. Doctors are very aware of HIPAA (and the equivalent in every other country), and the professional and monetary costs of non-compliance. Doctors didn't set up these systems. Doctors didn't expose them to the internet. As the other post said, vendors did. If those vendors couldn't properly communicate the needs, that's their problem. What I think is a more rational explanation for doctor (nurse, lab technologist, etc) resistance is that the industry is rife with incompetence and vendor balkanization. So much so that every healthcare professional deals with literally dozens of logins to try to do their job. Every one of those logins has its own bizarre password policies, rotation schedules, etc. Pretty soon there is rightly hostility to whatever scheme some small niche vendor has imagined up in the illusion of security.

txcwpalpha 7y ago
It may seem so, but I’ve done security consulting work for 10+ of the largest hospital chains and insurance providers in the country and I can assure you it isn’t an exception. Doctors don’t care about HIPAA (“that’s legal’s job”). They don’t care about the company’s finances (unless it’s a small private practice, “that’s the accountant’s job”). Some of the complexity is caused by the software itself being complex, yes, but that’s not what I’m talking about. In every organization I have worked with, doctors were always the biggest obstacle to even doing something as simple as requiring them to carry around a badge for physical access to the building. As a group, they are very resistant to anything that might add an extra step to their workflow. And yes, everyone hates and is resistant to stuff being added to their workflow, but I find most people are amenable to it as long as it’s a small interruption and it’s for a good reason (security). Doctors generally don’t have that attitude, though.
- dkdklk 7y ago
  Sounds like someone has it in for doctors. I worked in healthcare IT for years, before than going to medical school, and now in residency. My experience really does not match yours. As mentioned earlier in the thread, I will agree that doctors in general are quite resistant to technology because they have been fucked over by implementations that are more concerned with billing and regulatory than either better patient care or improving physician quality of life/workload. Most medical facilities use badges for access. I think what you’re calling resistance is increased scrutiny, something you might not be used to dealing with in other fields. Based on your sweeping generalizations tinged with bitterness I can only imagine most doctors that have to work with you professionally are going to be a bit on edge. The reaction you’re getting from all these physicians you’re working with is probably related to what I can only imagine is a shitty attitude.
  - jcims 7y ago
    Also in security for a long time, spending a lot of that with hospitals and healthcare organizations. My experience matches the parents. Your points are very valid but doctors can definitely be dicks as well.
  - wolco 7y ago
    Why you are resistant is important but you must follow the rules. Bad things beyond your imagination will happen if you click on that email link. The increased scrutiny allows for better patient tracking and care. That needs to be the priority. Regulatory paperwork and billing are the reason why you are putting in information into the computer. Without these the medical centre closes. Getting the correct information to that department is part of the role.
    - matz1 7y ago
      The better approach would be to automatically filter email containing dangerous link, or automatically prevent whatever dangerous thing that happen when that link is clicked. Is it hard ? Sure, the goal is to maintain security without creating additional burden to the user.
thomasfedb 7y ago
I'm a student doctor with a CS undergrad. I'm constantly gobsmacked by how horrible the computer systems doctors are forced to use are. They're pretty much abusive to use. The hours and hours of physician time that are thrown away into mindless box-ticking, copy-pasting, button-pushing, and general head-banging is astounding. If doctors are resistant to new IT hurdles it is, at least in part, because they're already faced with a decathlon-esque ritual to achieve their basic day's work.
- hhas01 7y ago
  Yep. Never blame users for raging at the system until you understand the system as well as they do. Techies have it easy: they only have one job and that’s all they ever do. It looks very different from the other side. (Protip: The key to delivering successful software is not to learn programming, it is to learn your users.) (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.)
  - OnlineGladiator 7y ago
    > (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.) Why now more than ever?
    - hhas01 7y ago
      Growing complexity. Struggling scalability. Overspecialization. Balkanization. Failures of accountability. OP’s firsthand observation on the awful state of programmer-produced medical software, the original linked article, and notoriously lethal software disasters such as Therac-25 provide frightening cases in point. These things are not accidents. Programmers who only know how to program are as much use as managers who only know how to manage. And this world has far too many of both. Look, any idiot can hack teh codez. Learning the problem domain; that’s the hard part. It is also the critical core of the job. Because if you don’t/won’t/can’t understand the problem, how do you possibly expect to solve it? Especially when that problem space is something as vast, complicated, and utterly unforgiving as millions of people’s healthcare.

txcwpalpha 7y ago

It may seem so, but I’ve done security consulting work for 10+ of the largest hospital chains and insurance providers in the country and I can assure you it isn’t an exception. Doctors don’t care about HIPAA (“that’s legal’s job”). They don’t care about the company’s finances (unless it’s a small private practice, “that’s the accountant’s job”). Some of the complexity is caused by the software itself being complex, yes, but that’s not what I’m talking about. In every organization I have worked with, doctors were always the biggest obstacle to even doing something as simple as requiring them to carry around a badge for physical access to the building. As a group, they are very resistant to anything that might add an extra step to their workflow. And yes, everyone hates and is resistant to stuff being added to their workflow, but I find most people are amenable to it as long as it’s a small interruption and it’s for a good reason (security). Doctors generally don’t have that attitude, though.

dkdklk 7y ago
Sounds like someone has it in for doctors. I worked in healthcare IT for years, before than going to medical school, and now in residency. My experience really does not match yours. As mentioned earlier in the thread, I will agree that doctors in general are quite resistant to technology because they have been fucked over by implementations that are more concerned with billing and regulatory than either better patient care or improving physician quality of life/workload. Most medical facilities use badges for access. I think what you’re calling resistance is increased scrutiny, something you might not be used to dealing with in other fields. Based on your sweeping generalizations tinged with bitterness I can only imagine most doctors that have to work with you professionally are going to be a bit on edge. The reaction you’re getting from all these physicians you’re working with is probably related to what I can only imagine is a shitty attitude.
- jcims 7y ago
  Also in security for a long time, spending a lot of that with hospitals and healthcare organizations. My experience matches the parents. Your points are very valid but doctors can definitely be dicks as well.
- wolco 7y ago
  Why you are resistant is important but you must follow the rules. Bad things beyond your imagination will happen if you click on that email link. The increased scrutiny allows for better patient tracking and care. That needs to be the priority. Regulatory paperwork and billing are the reason why you are putting in information into the computer. Without these the medical centre closes. Getting the correct information to that department is part of the role.
  - matz1 7y ago
    The better approach would be to automatically filter email containing dangerous link, or automatically prevent whatever dangerous thing that happen when that link is clicked. Is it hard ? Sure, the goal is to maintain security without creating additional burden to the user.

thomasfedb 7y ago

I'm a student doctor with a CS undergrad. I'm constantly gobsmacked by how horrible the computer systems doctors are forced to use are. They're pretty much abusive to use. The hours and hours of physician time that are thrown away into mindless box-ticking, copy-pasting, button-pushing, and general head-banging is astounding. If doctors are resistant to new IT hurdles it is, at least in part, because they're already faced with a decathlon-esque ritual to achieve their basic day's work.

hhas01 7y ago
Yep. Never blame users for raging at the system until you understand the system as well as they do. Techies have it easy: they only have one job and that’s all they ever do. It looks very different from the other side. (Protip: The key to delivering successful software is not to learn programming, it is to learn your users.) (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.)
- OnlineGladiator 7y ago
  > (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.) Why now more than ever?
  - hhas01 7y ago
    Growing complexity. Struggling scalability. Overspecialization. Balkanization. Failures of accountability. OP’s firsthand observation on the awful state of programmer-produced medical software, the original linked article, and notoriously lethal software disasters such as Therac-25 provide frightening cases in point. These things are not accidents. Programmers who only know how to program are as much use as managers who only know how to manage. And this world has far too many of both. Look, any idiot can hack teh codez. Learning the problem domain; that’s the hard part. It is also the critical core of the job. Because if you don’t/won’t/can’t understand the problem, how do you possibly expect to solve it? Especially when that problem space is something as vast, complicated, and utterly unforgiving as millions of people’s healthcare.