Information technologies have significantly contributed to the evolution of work over the last fifty years. At first, IT was primarily applied to automate back office, highly repetitive and fairly standardized tasks, such as financial transactions, payroll, and inventory management. The machine-like nature of these tasks made it possible to develop data processing applications that no longer required a human in the loop unless there was a problem.
As time went on, IT was increasingly applied to interactive applications that enabled people to do for themselves tasks that previously required human assistance. For example, the advent of ATMs in the '70s, allowed people to get money on their own without having to go to the bank and queue up in front of a teller. Word processing applications in the 1980s enabled people to type or at least edit their own documents without requiring the services of a professional secretary. Computer-assisted design (CAD) applications have proved invaluable for engineers and architects, significantly cutting down the effort involved in their various design tasks.
Customer self-service was arguably the commercial killer-app of the Web in the '90s. It seemed almost magical how easy it was to now do for yourself so many activities that previously required a trip to a store or office, or at least a phone call during office hours. All of a sudden you could track the status of your packages, access tax information, check the weather of any city in the world or buy a book with nothing more than a browser and an Internet connection.
Beyond back-office automation, personal productivity and customer self-service, I believe that the collaborative Web is now ushering us into the next major phase in the evolution of work, especially as it applies to services. Services essentially involve people interacting with each other - e.g., healthcare providers and patients, teachers and students, financial advisors and clients. It has been very difficult to apply IT to these activities because the human interactions are an essential part of the work, and the unstructured, highly variable nature of these interactions defies automation, no matter how powerful the computers are.
But the emergence of social networks, Web-based collaborative platforms, wireless communications, mobile devices and Internet-enabled sensors of all sorts over the last few years has enabled us to apply IT to these people-oriented social systems. The aim is not to get people out of the loop, but to make the overall service experience more productive and of higher quality – that is, more satisfying for both clients and providers.
Let me give a few examples in healthcare - perhaps the industry in direst need of productivity improvements to reduce rapidly rising costs, and of quality improvements to reduce mistakes and unnecessary complications.
In MIT’s Engineering Systems Division (ESD), we are trying to define a new project to see how best to apply to healthcare systems the kind of engineering practices that have been successfully applied in a variety of industries, such as automotive - e.g., Lean Production, Six Sigma and Project Management. This is particularly difficult in healthcare, because it involves so many diverse people - patients, physicians, nurses, administrators, insurers, care-givers, patients' families - and so many different tasks - many fairly routine, most probably not. Consequently, the healthcare industry is significantly behind in its use of IT and systems thinking, compared to just about any other industry.
In my opinion, the key to making progress is not to focus on automating tasks that defy automation, but to include all these parties as part of the healthcare system by giving them tools and platforms so they can better communicate, share information, and collaborate.
For example, at a seminar in MIT last December, the CEO, CIO and Chief Medical Officer of the Vassar Brothers Medical Center told of their Medication Bar Coding initiative, which is designed to significantly reduce the error rate in administering medications to patients in the hospital. The frequency of such errors is surprisingly high, including serious ones that require follow-on treatment. Not only is this dangerous to the patients, but it is also very expensive for the hospitals, as each intervention to treat the consequences of a serious medication error is estimated to cost the hospital around $10,000.
The wireless-based Medication Bar Coding solution requires that a nurse perform three scans before giving medications to a patient. First they scan themselves, then the patient, then the vial containing the medication. Only if all three scans are correct and the computer flashes a green sign will the nurse administer the medications. Using this simple scanning technique - similar to techniques widely used on factory floors and in transportation logistics, supply chains and other engineering systems - Vassar Brothers Medical Center has eliminated almost 90% of the serious errors incurred in administering medications.
You can imagine extending such relatively simple techniques to help reduce other serious but preventable medical problems. Perhaps, for example, there could be some kind of audio signal as soon as someone gets close to a patient to remind medical personnel to sanitize their hands before touching each new patient, and thus help reduce MRSA - antibiotic resistant bugs that are widespread in hospitals and infect a sizable number of patients. Patients with MRSA infections have considerably higher risks of in-hospital death, and require significantly longer and more expensive hospital stays.
Given that collaborative solutions are generally quite effective, we could have the patients themselves reset the hygiene reminder signal, thus helping them watch out for their own well-being. If a patient is too sick to push a button, perhaps the attending nurse can do so for him or her. As with similar Lean Production methodologies, all the information should be captured and stored, so that when a patient does catch an MRSA infection, medical personnel can analyze the information, try to determine the root causes of the problem and take the necessary steps so that similar problems will be prevented in the future.
Another very interesting research project involving collaboration and patient empowerment is taking place at MIT's Center for Collective Intelligence. The project's title is self-descriptive: Harnessing the World's Collective Intelligence to Cure My Cancer. It aims to establish social networks, each focused on a specific disease, and link together a worldwide network of people, information sources and tools. It will then use a variety of raw data, clinical practices and basic medical research to make predictions and recommendations for individual patients. As more data is gathered, as the tools get better and as people learn how best to work with each other, the predictions and recommendations should improve.
One of the most innovative research projects I have seen in a while is The Huggable, which is taking place in the Personal Robots Group at MIT's Media Lab. The Huggable is a robot designed as a companion for a variety of users, such as the elderly, the very young and people suffering from cognitive disabilities. It is essentially a cute teddy bear, with a sensitive skin, an embedded PC, wireless communications and the ability to handle vision and auditory processing. But most important, the Huggable is a tool to facilitate interactions in health, education and social communications. It enables its users to be part of a human social network of therapists, care-givers and/or family members.
Most work involves teams of people - employees, customers, service providers, business partners - collaborating with each other in various combinations. Until recently we did not have the proper technologies to enhance such collaborative work. Now that we do, we can expect a whole new round of innovations designed to improve the productivity and quality of work well into the 21st century.