I worked in health care tech for about 5 years. AI driven before it was cool. Took processes that normally took years down to a couple hours. Cutting edge stuff.

What struck me over the years was the open hostility we faced from the staff. The admins would buy our product, then have us come do trainings. The clinicians seemed to resent every second of it and would just never use the tool.

Towards the end of my tenure there, a PM said to me “the last thing these people want is to have to learn yet another workflow”. Which is when the penny dropped for me that our tool was just one of a bazillion being force fed to these poor people. They want to spend their time with patients not a screen.

Despite it being the most mission driven I have ever felt about a product (we were literally trying to help cure cancer lol). I’ll never work in health care again. Like education, it’s a quagmire.

> Towards the end of my tenure there, a PM said to me “the last thing these people want is to have to learn yet another workflow”.

I suspect that people entering medicine do so to address human needs, and have very little interest in dealing with technology (or handling traditional paperwork for that matter). Couple that with a perception that pretty much anything digital being obsolete before it reaches market, and even more so when it can take upwards of a decade for the product to reach them, and you are left with a group of people who have nothing but dread about being stuck on a never ending treadmill that is outside their scope of interest and expertise.

Take that opinion with a grain of salt though. My background is in that other quagmire: education. I have seen some amazing tools developed over the years that were abandoned, so everyone had to move on. Worse yet, no replacement was created for most of those tools so everyone is back where they were before the revolution happened. (I'm thinking specifically of software used by teachers and administrative staff, but something similar can be said for software used to deliver the curriculum.)

> I’ll never work in health care again. Like education, it’s a quagmire.

Remember: there's a lot of "health care" out there. Even if doctors resent EHRs, there's also drug discovery software, telehealth software, embedded software in medical devices, etc!

In fourteen years at one hospital we have had two completely different EMRs as well as the old electronic record system that didn't have charting but allowed lab lookup, scans of documents, etc. The two older ones are still running in read-only mode because Epic can't look at them, so any records older than 2022 are only in there.

Cardiology, radiology, endoscopy, and labor and delivery all have their own systems for their internal usage while releasing final results to Epic.

I don't object to the idea that these products are made for admins. It's a business and it needs to make money to survive. I object to the idea that making a product for sale to admins precludes making it at least usable for those who actually put in the data.

It’s more than that actually. Where is actual interop? It’s been promised literally 10 years ago. It’s not that hard. People in Healthcare IT are just that bad.

The only time I’ve experience interop in healthcare is due to actual organizations merging. That’s it. This entire space is filled with incompetence. Maybe providers will actually use the tools if they work consistently. Food for thought.

Most of my experience is on the pharmacy side, and tech basically saved pharmacy, from recordkeeping, insurance claims, accounting to inventory.

But it was voluntary (for the organizations, not so much the staff). There was no need for government to shower pharmacies with money to adopt it because it paid for itself.

I'm sure a lot of the staff initially met it with the same hostility. Even in 2010 when I was more in the field, we still had staff where their only computer experience/use was at work and otherwise lived an offline life.

Can't say I saw a pharmacy that didn't have a computer since the early 90s in Canada (and my memory doesn't go before that). And before that, at least they used typewriters. Meanwhile my GP was all-paper well into the 2000s except for some billing stuff. God help anyone that had to read his notes. But sometimes you're reimbursed sufficiently that there is no driver to change workflows even if it would be economic.

Ontario Canada.

That resistance to change is just human nature. I work on much lower stakes line of business apps and the new thing can be _objectively_ better in every way and there will still be significant pushback from a large percentage of the userbase.

I work in hospitals and it's just a constant stream from IT of "oh you just figured it out! congratulations! time to change they way you do things! this time we've solved all your problems that you're not complaining about! try to reengineer how to do anything now! lol! we hear you and feel your pain! here read ten pages of drivel that tells you how important and amazing IT is but won't actually tell you how to do anything with the new new tools and lives in some fantasyland that has nothing to do with the work that you actually need to get done!" all while simultaneously making every single computer and workflow somehow slower and more complex. Add another login here... force a quicker logout there... And then admin will come in with "thanks IT! you're doing amazing work! by the way everyone else we expect your productivity and caseload to increase!"

Meanwhile getting things to work is filing tickets followed by "oh gosh that's so complex!" and months of moron pitcrew showing up " to fix it" who can't fix anything and who seem to think it's just that we're dumbasses who can't figure out who to reboot a computer.

Honestly it's difficult to not grow the instant opinion that IT should just shut the fuck up and fire themselves. Who the hell do they even work for?

> we were literally trying to help cure cancer lol

Project Ronin?

Yeah doctors hate them because it's just shit software. It's something like Workday trash - software that's made to be extendable to every possible use case and save costs for the developer while being complete garbage to use. Even if it did work, it's then tailored to the priorities of legal and management rather than doctors.