The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

Abstract

Though Dr Robert Wachter is known for coining the term “hospitalist” and launching a new medical specialty, this book is his sixth and he is clearly an author whose talents go far beyond that simple sound bite. In The Digital Doctor, Dr Wachter deftly explains the complex interaction of medicine and information technology. The book is meticulously researched, including interviews with a diverse assortment of frontline clinicians, information officers, and policy makers, as well as background research on the evolution of medical documentation. Going beyond an analysis of work flow, Dr Wachter also details the impact of information technology on physicians’ relationships with their patients and their colleagues.The book is divided into 6 parts, the first giving the history of medical documentation, and the last, a view on what the future holds as information technology is increasingly embedded in health care delivery. The middle sections each describe a different mechanism by which information technology affects health care. What makes this book captivating is that in all sections, Dr Wachter uses clinical examples, from his own experience and the narratives of those he interviewed, to bring the concepts to life. The best example is in part 3, in which he dissects the sequence of events that lead to a medical error, graphically illustrating the tragic limitations of electronic systems in guaranteeing patient safety.This book is an excellent read for clinicians who seek a better understanding of electronic health record functionality, for information technology experts who need to comprehend the unique business of health care, and for health care consumers grappling with the impact of technology on their experiences. On a superficial level, Dr Wachter’s description of providers frustrated with electronic health record implementation is reassuring. On a deeper level, the book’s explanation of the diverse and complex applications of health care technology—to ensure correct billing, to avoid malpractice issues, to meet federal requirements—lends a concern that the welfare of patients is only a single entity in a long list of priorities. Fortunately, patient care is clearly at the forefront of Dr Wachter’s analysis.The author’s unique and powerful understanding of the complexity of health care and information technology is exemplified in the following quote:This book is an insider’s view that will resonate with all members of the health care team.

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