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There was a case more than 20 years ago of a similar revolt against a Canadian hospital's automated drug dispensing machine that would only let nurses withdraw

There was a case more than 20 years ago of a similar revolt against a Canadian hospital's automated drug dispensing machine that would only let nurses withdraw the exact dose of medicine a patient needed in a short window around when patient was supposed to take each dose. It was so bad it got written up into an academic article: https://journals.sagepub.com/doi/abs/10.1177/016224390202700303 https://journals.sagepub.com/doi/abs/10.1177/016224390202700...

prox 4y ago
That reminds of that Star Trek episode “Critical Care” where people only get the resources allowed by an AI overseer. How does this even pass an early review?
- hotpotamus 4y ago
  It sounds a bit like the smart contract/DAO thing, doesn't it?
- dleslie 4y ago
  The problem with substance abuse, and stealing to sell, was then and remains now a widespread problem in Canada's hospitals.
  - prox 4y ago
    I feel this is more a society problem than a hospital problem, but not that familiar with Canada. Wouldn’t a digital key in a storeroom and camera on the drugs would be far more efficient? The nurses and doctors can still go in and check out what they take when they need it.
matheusmoreira 4y ago
> they resented features that controlled their time and their autonomy Of course. Nobody likes being controlled by software. The computer is supposed to obey us, not the other way around. Software controlling humans is a violation of basic human dignity.
- wombatpm 4y ago
  Computer says No
- zajio1am 4y ago
  Pretty much same argument could be said against checklists ('paper controlling humans is a violation of basic human dignity'), but it is a thing that consistently improves outcomes in medicine. In general, it is restricting autonomy in order to improve consistency and quality.
  - matheusmoreira 4y ago
    > Pretty much same argument could be said against checklists No, the same argument most certainly cannot be made against useful patient safety tools like simple checklists. Not only are they useful, they are simple and integrate seamlessly with pretty much any workflow without obstructing them. Meanwhile poorly designed software can go so far as to actively impede the work being done which I have no doubt is the case of the software described above and its micromanagement of nurse's work.
    - fomine3 4y ago
      Bad paper forms also makes things bad. It's not only the software's problem but the system's problem that human make. Valid criticism for current software system is that it's hard to improve without programmers who work for it.
      - matheusmoreira 4y ago
        Bad paper forms can at least be ignored or partially filled. Software can enforce validation and actively impede work until the constraints are satisfied. > it's hard to improve without programmers who work for it Any programmer who wants to improve things should probably volunteer at a local hospital or shadow a physician in order to grok what the actual work is like. Ergonomics means adapting the work to the human, not the human to the work. In my experience, healthcare software is all about the latter and it really shouldn't be. I guarantee programmers would hate it if they were forced to use tools that were as hostile to them as healthcare software is to staff.
becurious 4y ago
Diversion of painkillers is unfortunately a thing and so those are often now in computer controlled cabinets that track dispensing. It’s the right thing to do because if a HCP is doing this they need help.
deleted 4y ago
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prox 4y ago

That reminds of that Star Trek episode “Critical Care” where people only get the resources allowed by an AI overseer. How does this even pass an early review?

hotpotamus 4y ago
It sounds a bit like the smart contract/DAO thing, doesn't it?
dleslie 4y ago
The problem with substance abuse, and stealing to sell, was then and remains now a widespread problem in Canada's hospitals.
- prox 4y ago
  I feel this is more a society problem than a hospital problem, but not that familiar with Canada. Wouldn’t a digital key in a storeroom and camera on the drugs would be far more efficient? The nurses and doctors can still go in and check out what they take when they need it.

matheusmoreira 4y ago

> they resented features that controlled their time and their autonomy Of course. Nobody likes being controlled by software. The computer is supposed to obey us, not the other way around. Software controlling humans is a violation of basic human dignity.

wombatpm 4y ago
Computer says No
zajio1am 4y ago
Pretty much same argument could be said against checklists ('paper controlling humans is a violation of basic human dignity'), but it is a thing that consistently improves outcomes in medicine. In general, it is restricting autonomy in order to improve consistency and quality.
- matheusmoreira 4y ago
  > Pretty much same argument could be said against checklists No, the same argument most certainly cannot be made against useful patient safety tools like simple checklists. Not only are they useful, they are simple and integrate seamlessly with pretty much any workflow without obstructing them. Meanwhile poorly designed software can go so far as to actively impede the work being done which I have no doubt is the case of the software described above and its micromanagement of nurse's work.
  - fomine3 4y ago
    Bad paper forms also makes things bad. It's not only the software's problem but the system's problem that human make. Valid criticism for current software system is that it's hard to improve without programmers who work for it.
    - matheusmoreira 4y ago
      Bad paper forms can at least be ignored or partially filled. Software can enforce validation and actively impede work until the constraints are satisfied. > it's hard to improve without programmers who work for it Any programmer who wants to improve things should probably volunteer at a local hospital or shadow a physician in order to grok what the actual work is like. Ergonomics means adapting the work to the human, not the human to the work. In my experience, healthcare software is all about the latter and it really shouldn't be. I guarantee programmers would hate it if they were forced to use tools that were as hostile to them as healthcare software is to staff.

becurious 4y ago

Diversion of painkillers is unfortunately a thing and so those are often now in computer controlled cabinets that track dispensing. It’s the right thing to do because if a HCP is doing this they need help.

deleted 4y ago

[deleted]