Secondly, even though technology is much more common (particularly with the younger generations), technological sophistication is still fairly rare. The vast majority of people use the technology of their jobs in the most narrow ways possible, and further they expect technology to "just work". When it doesn't, they call on the IT guys, or they call on their uncommon coworkers like me who aren't in IT but are still the unofficial IT guys by virtue of having more than modest computer knowledge.
Uh huh. I'm not falling for their cover-up!
A major related problem is that hospitals and other organizations get stuck using poorly-implemented devices because they are too fucking expensive to replace with something else. The expense in and of itself isn't totally unreasonable, because manufacturers of medical devices need to comply with a great deal of regulations and safety testing. However, that doesn't help the users any.
The hospital I work at, for example, bought a software suite years ago for our pharmacy and financial departments to use, and about a year ago it was rolled out to all other departments in our transition to electronic records. This software is some of the most clunky, ham-fisted crap I've ever seen. We despise the software for a great number of reasons (not the least of which is that it actually takes 2-3x LONGER to do anything than it did with our old paper records), and with the push to get all hospitals and medical offices using electronic records, something better would be most welcome. Unfortunately, with what we paid (and continue to pay) for the software contract, there's no budget to get something different and probably never will be because as far as the board is concerned it does what we need it to do.
Agreed. A lot of people are so quick to suggest that Facebook is going to turn out like Myspace in a matter of months but in reality that really couldn't be further from the truth...
If you want to see the digital equivalent of tumbleweeds, go check out MySpace. Just for the hell of it, I logged into my MySpace the other day for the first time in many months, and the only thing I saw there was dozens of bulletin posts by one band whose posts I used to ignore every couple days. About 4 years ago, MySpace added a bunch of worthless features (apparently trying to copy the increasingly popular Facebook) and increasingly in-your-face advertisements, and not coincidentally most people made the migration to Facebook. Then about 2 years ago, Facebook started adding a bunch of features that reminded a bunch of us of MySpace's missteps... but oddly enough, people didn't migrate away. They do seem to have a much better thought-out system, and their people-searching is top notch. Facebook probably will go away in a few years and be replaced by something else, but it's definitely not fading away in the foreseeable months.
The reason we have overtesting in the U.S. is because doctors get paid by procedure, not because patients don't have to pay for it.
That's a bit of an oversimplification. Though that definitely does occur with some (I'll even grant you many) doctors, a more accurate simplification is that we over-test for liability reasons, (and if the patient has insurance or medicare, they are much less likely to refuse needless tests that they can't afford). Consider a patient presenting to an ER with a complaint of chest pain. This is a very common complaint with many possible causes, and I'd roughly estimate that at least 95% of them are not having a heart attack. Much more commonly the chest pain is due to anxiety, or muscle pain, or inflammation of the cartilage attaching the ribs to the sternum.
However, only a handful of ER doctors would be comfortable sending the patient home, so these people are almost always kept overnight for observation ($) and receive a series of blood tests ($$), EKGs ($$$), a cardiac echo ($$$$) and cardiac stress test ($$$$$), and many have a cardiologist consulted for his opinion ($$$$$$). After all of this, the patient is discharged the next day with none of us knowing anything more than we knew before they arrived. We're not like a restaurant: even if the meal came with all kinds of toppings and sides you didn't ask for, you're still responsible for the bill.
This quandary is similar for many health problems (abdominal pain being another very common complaint with dozens of possible causes but only a handful of them serious). As the expression goes, "when you hear hoof-beats: think horses, not zebras". It's a sensible expression, but instead of following it we do every test conceivable for zebras, because we're terrified that one of these times the zebra's going to come charging out of the shadows and trample our finances in court. The worst part is, the insurance companies tacitly encourage this needless testing because the zebra tests are a lot cheaper than the actual zebra and its accompanying lawsuit if it's not caught.