A Different Real-Time Web

I've often thought it strange, when watching a TV medical drama, to see amazingly realistic shots of surgical procedures, followed by scenes of what must be pure fiction, where the doctors are spurred into action via a page, from one of those 1980s pager things on their belt.

Come on, nobody these days actually uses a pager, do they?

Well, I learned today from an expert in medical informatics that pagers are alive and well in hospitals because they so effectively reduce the latency between when a message is sent and when it's received. "In patient care, a minute will make a big difference", he said.

Ironically, this came up in a conversation about how his hospital could extend their existing social networking implementation into the realm of patient care, in particular the possibilities for using internal micro-messaging tools (a secure internal Twitter-like app) to improve communication between the people treating each patient.

In the long term, hospitals will embrace such tools for the obvious patient benefits. Patient care teams provide an excellent use case for micro-messaging, because team-wide status updates enable faster, more error-free transfer of patient information from one team member to another. In an ICU (intensive care unit), for instance, a technician signaling that a patient's respirator had exceeded some limit would enable the nurses, residents, and attending physician to more quickly assess and treat the patient's emergent condition.

Why in the long term? Because people in medicine are not eager to adopt new technology. As a patient, I can understand why. Would you want your doctor treating you with some new but not thoroughly tested device?

And that's why pagers persist to this day. In a clinical context, a page may carry less information than a micro-message or an email, but it's less risky.

Only some of this is due to its lower latency; the cultural practices that grow up around a technology are also important. Email, for instance, is such a bullying time-suck that many people let their inbox become a "to-do" list that runs their lives. By contrast, a page is culturally understood to have immediacy, which frames the timeline in which you're expected to respond.

Social media will eventually have a deep and profound impact in the health care sector, as elsewhere. But don't be surprised if the medical community takes a lot of time to apply these new tools, operating as they do from a prime directive – first, do no harm.