<story><title>Why Doctors Hate Their Computers (2018)</title><url>https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers</url></story><parent_chain><item><author>cs702</author><text>Doctors hate their computers because the software they are forced to use &lt;i&gt;sucks&lt;/i&gt;.&lt;p&gt;And it sucks for the same reason that most enterprise software sucks: because &lt;i&gt;the people who budget for it, choose it, and pay for it are not the people who use it&lt;/i&gt;.&lt;p&gt;For more on this, see this now-classic Twitter thread by Princeton CS Prof Arvind Narayanan:&lt;p&gt;&amp;quot;Why Enterprise Software Sucks&amp;quot;&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;twitter.com&amp;#x2F;random_walker&amp;#x2F;status&amp;#x2F;1182635589604171776&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;twitter.com&amp;#x2F;random_walker&amp;#x2F;status&amp;#x2F;1182635589604171776&lt;/a&gt;</text></item></parent_chain><comment><author>pavon</author><text>To expand on that EMRs, much like SAP and other enterprise offerings aren&amp;#x27;t so much fixed pieces of software as ridiculously flexible frameworks for making software. And the people deciding how to configure Epic, and deciding how the doctors and nurses need to use it aren&amp;#x27;t practitioners, they are administrators who are making decisions for bureaucrats reasons, CYA being high on the list. Anytime an accident occurs, rather than understanding why it occurs, the solution is always to add more administrative controls, to record more details in the chart, more busy work to do that makes each step of the process take longer.&lt;p&gt;As a result, the number of things that practitioners need to enter into EMRs keeps growing, and every year they spend more and more time charting. This in turn decreases the signal-to-noise ratio of the information in the charts, resulting in the practitioners getting less information out of them despite the fact that more information keeps getting put in. Which results in more accidents rather than less.</text></comment>
<story><title>Why Doctors Hate Their Computers (2018)</title><url>https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers</url></story><parent_chain><item><author>cs702</author><text>Doctors hate their computers because the software they are forced to use &lt;i&gt;sucks&lt;/i&gt;.&lt;p&gt;And it sucks for the same reason that most enterprise software sucks: because &lt;i&gt;the people who budget for it, choose it, and pay for it are not the people who use it&lt;/i&gt;.&lt;p&gt;For more on this, see this now-classic Twitter thread by Princeton CS Prof Arvind Narayanan:&lt;p&gt;&amp;quot;Why Enterprise Software Sucks&amp;quot;&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;twitter.com&amp;#x2F;random_walker&amp;#x2F;status&amp;#x2F;1182635589604171776&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;twitter.com&amp;#x2F;random_walker&amp;#x2F;status&amp;#x2F;1182635589604171776&lt;/a&gt;</text></item></parent_chain><comment><author>kube-system</author><text>To be fair, the people who use enterprise software typically only understand a single-digit percentage of what the software needs to do, at best.  If you asked them to design it, you wouldn&amp;#x27;t get a better result.&lt;p&gt;To properly architect enterprise software, you need to capture the competing needs and goals of hundreds of different roles in different departments.  You will uncover underlying political and organizational issues that you will need leadership to sort out before you can ever start to determine the business-logic.  To be successful, you have to be an expert at playing politics, business analysis, and mediating conflict.&lt;p&gt;I wouldn&amp;#x27;t say &amp;quot;enterprise software sucks&amp;quot;... more like, the lack of cooperation in many organizations sucks, and enterprise software puts a big spotlight on it.</text></comment>