Digital health, seen from a ward

Work on a surgical ward is not a sequence of tasks. It is a day full of interruptions: a patient calls, a colleague needs a decision, a family waits in the corridor, and somewhere in between the notes still have to be written. Software designed for a calm, continuous working day will not survive a Tuesday morning.

So the first thing I look at is not the interface. It is how many steps a product adds to something that until yesterday took none. If documenting a wound takes four taps instead of one line of handwriting, the tool will be abandoned, however elegant it looks in a demo.

In an emergency department, information arrives incomplete and late, and a decision has to be made anyway. Good software does not pretend otherwise. It shows what is missing, keeps the handover in one place, and does not bury an abnormal value among twenty normal ones.

Alert fatigue is not a detail of design. It is a clinical risk: a system that cries wolf trains people to stop reading it, and then the one alert that mattered goes past unnoticed.

Preventive medicine and longevity interest me, and so does the risk built into them. The easier something becomes to measure, the more tempting it is to measure it in people who would never have been tested, and to treat a number instead of a person.

A tool that produces findings owes the user a second thing: what to do with them. Sometimes the honest answer is that nothing needs doing, and the check can wait a year. A product that cannot say that is not being careful.

As Chief Medical Officer at Elty I spend part of my time on the clinical side of the product, which mostly means asking the same three questions. Does it survive a busy day? Who is better off after using it, the clinician or the patient? Can one colleague explain to another, in a single sentence, why the change is worth it?

If the third question is hard to answer, the first two rarely matter: the tool will be installed, used for a month, and quietly dropped.

I also know the limit of this view. I see technology where it meets a patient, inside a hospital with limited time and a long queue. That is a narrow angle, but it is the one I trust, and it is the one I write from.