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

The Digital Doctor explores new developments in IT healthcare and its future benefits.

You’re in a hospital room with a video screen and cameras. Your head throbs. You say, "Nurse, I’m in pain," and a nurse appears on the screen across from you. After asking a few questions, she says you’ll get a Tylenol shortly. A few minutes later, a robot enters the room and gives you a pill and some water to wash it down.

This may sound like science fiction, but according to The Digital Doctor, healthcare could look like this in the near future.

The Digital Doctor covers issues around the push to digitize healthcare in the US. Written by Robert Wachter, a doctor at the University of California San Francisco Medical Center, the book addresses how health IT has impacted doctors and patients, and, among other things, what the ultimate vision for healthcare IT should be.

Wachter argues that while technology has the ability to greatly improve healthcare, it is also fraught with problems.

No one knows this better than Pablo Garcia, a patient who was accidentally given 38½ times the dose of a drug he had been taking. The author shows that it was no simple error. In a play-by-play from each participant’s perspective, we see how the system’s coding and the process of human checks and balances, designed as a safeguard against such catastrophes, failed. It was a perfect storm of oversights that led to the very rare level of overdosage that almost cost 16-year-old Garcia his life.

Will new technology render humans obsolete? Wachter contends that, even with artificial intelligence, machines can’t replace humans in medicine. Doctors, unlike computers, can look at more than just numbers. Two patients may have the same temperature, heart rate and blood counts, for example, but an experienced doctor can look at both and determine that one is sick and the other is healthy.

Wachter has a depth and breadth of perception that could only come from being on the front lines. He shows the effects of health IT in everything from wide-ranging public policy regulations to the dangers of something as minuscule as forcing medications to be ordered in either milligrams or milligrams per kilogram.

Wachter doesn’t forget the human component, and stresses that others in this brave new world shouldn’t, either. "Even if we get the technology right," he says, "it is the job of the medical profession to constantly emphasize that it is the patient — a human being… who is the object of our care, not a digital incarnation."

The Digital Doctor presents a great deal of food for thought but, despite being written for the layperson as well as the medical professional, the book is a little too heavy on clinical jargon. All in all, however, it’s an insightful look at a system moving into the 21st century.