Saturday 9 June 2018

Welcome to the ecare system

In the last month, my husband lived in hospital for over a week. He was admitted through the emergency route on his 7th chemotherapy cycle.

A week. The longest time he has yet needed to stay. Not surprisingly, he is depressed, tired, upset, and angry. Told he can go home, this is suddenly denied him and he must stay for another day. Then another 8 hours. Someone didn't scan down the onscreen information, you see? They only looked at the first line, and the second line gave different information which would have meant a different instruction and a different result.

My husband is close to crying. He wants to cry with frustration. He wants to come home. I feel him lost in the hospital and, as I make another trek across the hospital grounds, I am afraid of the future.

Anyway, background information about my husband, whom I have known for 30 years, it doesn't matter. Neither does his name matter, and neither does any interaction anyone might have with him.

None of this matters because now he is a barcode that needs scanning.

When his barcode is scanned, the computer screen instructs the assistant. The assistant looks at the screen. They do what they are told. Then they leave the room where my husband stays alone.

When the nurses, students and assistants come to scan the barcode, these are the four interactions I have heard offered to my husband, who stays in bed day, after day, after day, while I am scared of the future.

I have numbered these interactions 1, 2, 3 and 4, for your reading convenience.

1. I'm just coming to scan your barcode.
2. Can I have your barcode?
3. Hmm. Barcode.
4. No words. (Nurse enters room, scans barcode, and leaves.)

These thoughts strike me.

Your nurse doesn't need to be human. Perhaps this would help, because then we wouldn't be disappointed. A robot doesn't care.

The doctor doesn't need to be in hospital. They could be sat anywhere in the world - the USA, India, Australia - a call-centre operative, outsourced in a globalised medical supply system. Professionals working quickly and remotely; scanning the onscreen information and sending instructions digitally. This would be easier. We wouldn't expect a human to smile.

In the old days, there used to be folders that followed you around. A person could scan, quickly, the pages of information to make a judgement. Yes, that liver function has always been high: a strange abnormality brought on by reactions to treatment. We can see how temperature follows the same pattern, so yes, let's use judgement now, in a stream of oversight, discrimination, speculation.

But that is old style. Folders are lost. Hand writing is impossible to read. Mistakes are made. Reading from a screen, one line of information, without the oversight to impede the medical decision. We could fit in twenty patients an hour on such a rapid throughput.

I'm an old dinosaur. I don't belong in this world. There is a bright new future, and I'm not part of it. The healthcare services are now looking to 5G: robotic surgery, wearable devices, online doctors, remote procedures. Technological transformation of medical services brings in consumers and markets, buyers and sellers. New markets. New economies. The healthcare budgets of old nations are vast.

This is the language of healthcare. It is of the economy. It is 'new value chains' and 'beneficial partnerships'. They will 'improve resource efficiency' and 'meet consumer demands for greater convenience and freedom of choice' with 'value for money'. This 'technological transformation' will offer 'opportunities for telecom operators to penetrate new value chains'.

But the loneliness, confusion, and dismay that might result from an all-computer system, we could deal with, couldn't we? We could access the hospital range of touch-screen devices to amuse us as we sit alone in our isolation wards and side rooms. Viewing packages available on request. Prices range from day rate to long-term. This is e-care. Enjoy your stay.

No comments: