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The Digital Divide: Promise versus Delivery
The "digital divide", the gap between those with access to information technology and those without, gets a lot of play in the press and with politicians. It is always expressed as a problem that must be addressed. You typically hear of it in socio-economic terms:
It really is an important issue worthy of thoughtful discussion - but I'm not going to discuss this in this post. At least not this form of "digital divide" anyway.
We in corporate IT may be a little smug about the digital divide because for the most part we don't have to deal with it. Generally, the groups we serve are all on the same level of access to technology so we don't have to worry about the divide. There is however a digital divide that we do need to worry about. In geo-political terms it is not nearly as important as the issues above but it is a local issue for all of us. It is the digital divide between what technology promises (the potential of technology) and what it delivers (or how we use it). This divide between promise and delivery expresses itself in two ways.
The first type of divide is a basic failure of the technology itself. Perhaps the example that most of us are familiar with is Microsoft Windows. It's been around since 1985 and been modified many times and offers us new features and improvements with each modification. And yet, we still have the dreaded BSoD that plagues us and causes our users to question the technology and doubt its robustness. Other examples are the software salespeople "overselling" their technologies capabilities.
The second type of divide is one that is more directly under our control. It typically involves packaging technologies together or the full implementation of the technology. I saw a recent example of this just last week. My doctor wanted me to get a CT scan to help diagnose a problem (nothing life threatening or major, thank you) which needed to be done at a different facility. I made the arrangements and had the scan done without problem. It only took a few minutes and is quite amazing technology. It provides a 3-dimensional digital image by taking a series or layers of 2-dimensional x-rays. I took a look at the output and it is truly mind-boggling. It was when I was about to leave that the divide jumped up and hit me. The technician explained that it would take a couple of days for them to get the images to my doctor and that I should follow-up with him then. A couple of days????? We live in a digital age - we take digital images to provide a tremendous amount of detailed images but don't use digital technology to deliver this.
Somehow they failed to realize the full potential of digital technology. The medical industry in particular at least in my experience seems to excel in implementing point solutions without integrating them [Will Weider - is this right or am I completely off base this one?] but they are not alone by any means. The real value isn't in the technology but in how you use. Do we needlessly limit the value of technology by the way we deploy it?
What examples of this type of digital divide have you seen and how do you avoid creating a divide?
"digital_devide" photo by palmetshofer
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Posted by Mike on
April 21, 2008 in
Information Technology
, Strategy & Management
, Technology
| Permalink
In IT there is never one answer to a simple question. But let me admit that YES, in IT we are guilty of these point solutions and while some aspects of healthcare IT are well done, others are maddening.
I believe that, in large part, this is due to healthcare complexity. Just the financial aspects of healthcare are more complex than nearly every other industry. Then there is that whole "practice of medicine" thing. So, sometimes we draw arbitrary boundaries to projects just so we have something that is achievable. We have every intention of going back later and bridging the resulting divide.
Of course there are always human factors that are major contributors. I suspect that is what is at play here. Nearly every hospital has a digital imaging network that stores these images and makes them available online. If you had your CT done at one of our hospitals I could view it from any computer (but I wouldn't because that would be a privacy violation and an alarm would go off in our privacy officer's office).
Once the study is completed, it is electronically sent to the radiologist via workflow. Once the radiologist "reads" the images they dictate a report. At that point the study is considered to be completed. Only then is the report and image available available to the referring doctor via the hospital's computer system. Assuming that your doctor is not a technophobe that insists images be sent in hardcopy so s/he can avoid the computer system (that happens), the hangup is the time it takes for the radiologist to provide their interpretation. That time varies by hospital and the hospital's contracted radiology group. That can take anywhere from an hour (good) to a couple of weeks (bad). Rather than providing this long explanation it is easier for the radiology tech to tell you that it takes a while for the image to be delivered.
This is why you get three bills for a CT. One from your doctor, one from the hospital (we own the CT scanner) and one from the radiology group in the middle. I told you the financial side of healthcare was complicated.
Thanks for contributing to the healthcare economy. I am glad you are doing well. I love your blog.
Posted by: Will Weider | Will Weider | Apr 30, 2008 4:45:43 PM
Will,
Thanks for sharing your insight. Healthcare is a complex area with all the various parties involved and the regulations associated with it. Your explanation gives me a new appreciation for the task you face.
Mike
Posted by: Michael Schaffner | Michael Schaffner | Apr 30, 2008 8:19:55 PM