High tech–and what kind of touch?
March 7, 2007 reference service No CommentsI have unexpectedly spent the past eight hours with an ill family member at our new local hospital, the first six of those hours in the Emergency department. The hospital opened in October and I had hoped not to have reason to set foot in it for years to come. But you know the saying that “life is what happens while you are making other plans.” So it is sometimes.
I have never been the emergency patient, but nonetheless am grateful I can still count on one hand my experiences with emergency rooms . If you have ever been to a hospital emergency room, you know that the TV depiction of a swarm of medical personnel attending to patients “stat” does not reflect the reality of waiting and waiting and waiting and…waiting punctuated by brief interactions with medical personnel, almost always one staff member at a time. It is probably hubris and a case of taunting the gods to say it, but I have not been a hospital patient since 1980 and then was kept overnight for what today is an outpatient procedure. And it has been 17 years or so since a family member has been in a hospital overnight. So when I must visit a hospital I am able to look at the organization, its operations, and its services almost as if I were an anthropologist visiting an unstudied society.
Shortly after I did all of the paperwork with an intake receptionist and signing forms, etc., we dealt with the first of a number of medical personnel we have dealt with so far–and more yet to come. The first, a nurse, took the patient's blood pressure, temperature and pulse. Each measure involved a distinct single-purpose electronic technology. And each technology could be applied without any need for the nurse to touch the patient's body. It was not robotic care by any means. The nurse demonstrated care and caring. But it struck me how much the nurse relied on technology.
We rely on technology a great deal, too. Today's encounters with various medical technologies reminded me of reference librarians' varied uses of technology over the past 30 years. Any of us can buy low-end technologies to measure our own pulse, blood pressure, and body temperature. This reminds me of the CD-ROM database era during which we could perform a search for a patron or the user could perform his/her own search. The latter might not involve any interpersonal interaction with a library staff member.
Then there was the ultrasound equipment and procedure, conducted in some other part of the hospital. I was not able to observe this but I am pretty sure that this equipment is not end-user equipment. This reminds me of the early, early days of database searching 30 years ago. Then it was mediated searching conducted out of view of the user. A librarian who had received training used a dumb terminal to communicate with a remote mainframe. Results were delivered to the user for him/her to judge and to work with. Similarly, the results of the ultrasound were delivered to a physician to read and interpret. No-touch for the patient (at least from my waiting afar vantage point), but terribly important to the patient. For much of its history, high touch was the norm in reference service. Today high tech is ascendant. Did the high touch in reference service provide added value beyond the value of the information and/or instruction provided? If so, do our no-touch/high-tech information systems deliver that same value? If not, can they? If they can, how?
I don't have answers to these questions, at least not now. Nor do I yet have an answer to the question that brought us to the hospital more than eight hours ago. I certainly hope a doctor whom I know thus far only by name but hope to meet any minute now will explain to me what answer to that question has emerged from the various technologies, their data, the patient's self-report of symptoms, and another doctor's observations and hands-on (literally) examination.
