A viewpoint piece published in JAMA explored the advantages of healthcare system technology and the argument for “optimism” regarding the digitization of medicine.                                                          

As of 2018, fewer than 10% of hospitals are without an electronic health record (EHR) system, and although “gains in efficiency and productivity” have been minimal, Robert M. Watcher, MD, of the Department of Medicine at the University of California, San Francisco, argues that modern improvements in machine learning, artificial intelligence, and systems thinking have the potential to substantially improve the “quality, safety… and efficiency” of health care.

Highlighting the error-prone nature and inefficiency of paper records, Dr Watcher emphasized the modern use of EHR systems in medical record-keeping. Though these electronic systems have their limitations, future developments in the capacity for data extraction drive the author’s optimism for healthcare digitization.

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That advances in EHR systems efficiency have not been fully realized is an artifact of the “productivity paradox,” or the notion that productivity does not immediately improve with the implementation of information technology. Dr Watcher cited factory electrification and manufacturing digitization as examples of systems that overcame the paradox with 2 key developments: technology improvements and a “reimagining of the work.”

Health care is poised to overcome this paradox: EHR systems have seen substantial improvements in analytic technology, and machine learning has become a salient tool for some diagnostic techniques. These technological improvements, as well as “evolving models” of thought in health care are tantamount to overcoming the productivity paradox and optimizing electronic systems.

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Though obstacles in privacy and safety may inhibit the progress of healthcare digitization, the author asserts that progress in this field will allow for a higher standard of medical care and better health outcomes in the future.


Wachter RM, Howell MD. Resolving the productivity paradox of health information technology. JAMA. 2018;320(1):25-26.