Digital Health Promises Efficiency, Delivers More Work for Patients
Translated & summarized from Calcalist by baba
Israeli digital health services may be creating an illusion of efficiency by shifting work and responsibility to patients, according to Dr. Shirley Bar Lev. An analogy is drawn to a Houston airport that extended walking distances to improve passenger perception of wait times. A similar incident with United Airlines showed how algorithms can overlook human value, raising concerns about professional judgment erosion in healthcare. The challenge for Israel is to maintain human oversight and responsibility in healthcare, especially amid a doctor shortage.
The story in 5 lines · by baba
- Digital health services in Israel may be transferring work and responsibility from providers to patients, creating an illusion of efficiency.
- An airport's strategy of extending walking distances to improve perceived wait times is compared to digital health's approach.
- The 2017 United Airlines incident highlights how algorithms can prioritize efficiency over human considerations.
- Over-reliance on algorithms risks eroding professional judgment and organizational courage in healthcare.
- Israel faces the challenge of ensuring technology assists, rather than replaces, human decision-making in healthcare.
A modern management approach, exemplified by a Houston airport's solution to luggage wait times, prioritizes perceived efficiency over actual time savings. By extending the walking distance to baggage claim, the airport reduced passenger complaints, demonstrating that the experience of waiting matters more than the total duration. This principle, however, raises concerns when applied to digital health services in Israel.
Instead of shortening access to care, digital health platforms, bots, and interfaces may be shifting the burden of work, time, and responsibility from healthcare providers to patients. This creates an illusion of advanced self-service and efficiency, while patients actively engage in tasks previously handled by the system. This phenomenon mirrors the Houston airport's strategy, where passengers are kept moving but the core issue of waiting is reframed.
The article draws a parallel to the 2017 United Airlines incident where Dr. David Dao was forcibly removed from a flight. This event highlighted how systems designed for maximum efficiency can disregard human and professional considerations. The algorithm prioritized operational needs over the doctor's essential duty to his patients, illustrating that automated systems excel at calculating economic value but struggle with human value.
This reliance on algorithms, as argued by Dr. Shirley Bar Lev, poses a significant risk. As systems become more precise, humans tend to delegate not just calculations but also responsibility, leading to a decline in professional judgment and organizational courage. Instead of questioning algorithmic decisions, individuals may simply accept them, eroding the capacity for independent intervention.
In the context of Israel's healthcare system, this is particularly critical given the emigration of doctors due to difficult working conditions. While AI and bots are seen as potential solutions to staffing shortages, a shift from expert reliance to algorithmic reliance could further diminish the status of physicians. Doctors who merely approve system recommendations may experience a loss of professional autonomy and meaning. The true lesson from the United Airlines case, and by extension from digital health, is not that the algorithm was wrong, but that people stopped feeling responsible for correcting it. The challenge for Israel is to ensure that technology assists human decision-making rather than replacing professional authority and ultimate responsibility.