Patient Archive to Augment Human Work

A Technology That Augments Human Work Rather than Replaces It

by Georgia Hay and Florian Klonek

Technology all too often is designed to replace humans. But the best technology is that which actually helps humans to do their work better.

The Patient Archive is a great example of such technology.[1] It is used within the Western Australian Undiagnosed Diseases Program (UDP-WA) Expert Panel Meetings to help diagnose rare diseases – or to “solve the unsolvable”.

Patient Archive is a knowledge management platform that clinicians are encouraged to use to document patient-related information. Before the UDP-WA and Patient Archive was in place, clinicians had to go through literally hundreds of patient documents. In many cases, two clinicians treating the same patient would not even have access to the same patient-related information.

The new knowledge management platform collects this patient-related information from each clinician and everyone has instant access to it. As Gareth noted: “The information is all in one place” and “it can be accessed from secure computer in the WA health system”. Gareth also mentions that it makes the collection of clinical information about a child more efficient because information does not have to be duplicated.

The system also allows the team to compare phenotype descriptions with other rare cases worldwide. This looks for “the next case of”, that is it finds similar undiagnosed patients internationally, so together answers can then be found.

Importantly, Patient Archive does not just store this information – it organises and analyses it using sophisticated algorithms, significantly advancing  clinical practice and research in genetics, including the diagnosis of rare diseases. Since the Patient Archive is fed with text-based information, the internal algorithm organises the symptom descriptions and compares them with described criteria for thousands of documented diseases and provide the expert panel with suggestions.

Gareth’s perspective on how the technological change affects his work is very positive. He considers Patient Archive “as another part of the team – one that is free from cognitive bias”

is positive perspective is grounded in the way that technology has been implemented in the UDP. Since Patient Archive is only considered by Gareth as “one opinion out of many”, it does not enslave the clinicians to strictly follow its recommendations.

As a geneticist, Gareth has heard many times that technology will “take over the world” but he has never seen those predictions fulfilled. In contrast, his personal prediction is that “demand for, and the demands, of clinical geneticists will always increase” and that the increased use technology has rather caused the “rebirth of the generalist”. He added, “genes do not care what you trained in [they can affect many parts of the body] and patients probably care even less”).

Taken together, the Patient Archive is a good example of how technology can reduce cognitive demands of knowledge-intensive work and also how it enables (instead of enslaves) team coordination processes, supporting optimal delivery of patient care.

Reference

[1] The Patient Archive (http://www.patientarchive.org/#/home) was developed by the Phenomics Team at the Kinghorn Center of Clinical Genomics, Garvan Institute of Medical Research in collaboration with the Monarch Initiative, Genetic Services Western Australia and the Office of Population Health Genomics, Dept. of Health, Government of Western Australia.

New technology, new work

How do you bid on digital ads in milliseconds and make YouTube funnier? The Answer: Technology, where future work is happening today.

by MK Ward

There’s a big debate amongst scholars and futurists right now. One view is that the extent of digitalization has become so advanced that there will be huge job losses in the future, some predict as many as 40% of jobs[1] . But others argue this situation is an overstatement and new jobs will emerge, resulting in little overall job loss.

We don’t know which view will be right. But there is no doubt that new technology creates new jobs. Here are two interesting ones.

Imagine an advertising job with a difference. This job pushes the boundaries to use data from users to allow personal and precise advertising. Specifically, by analysing the individual’s via browsing habits, and by using product information from partner client sites, personal advertisements try to entice the user to go back to the site to purchase.

Matt, founder and manager of a digital company, describes an “interesting” further development in which companies engage in real time bidding for ad space on a website. The bidders are the demand-side platforms that are set up by companies who have created a bunch of campaigns. The bidders and campaigns may want to target a particular person who’s visited one of our e-commerce sites. When they come into that eco-system, which can be that the person is on news.com.au reading a news article, they might be a slot of space next to the article. That is the ad space that’s bid on. The highest offer (e.g. $5) from the bidders wins. The bidding space uses second price option where the highest offer wins but pays the loser’s offer or one cent higher. All of this happens within the time limit of 40ms from when the targeted person arrives to the webpage.

This is a current, local example of the types of jobs emerging in the advertising and media sectors.

A second example of work that you wouldn’t find 10 years ago, is Rajeev’s full-time job of watching YouTube and Facebook videos to find ones that are entertaining, but that “could be funnier” with different commentary.

Yes, you read that correctly… Rajeev works in the entertainment industry. His boss is an entertainer. Ranjeev’s job is to find videos online and then - once he has permission from the video’s owner – to create a different sound-over for a YouTube to increase its comedic value. Sometimes the fans do some of the work for Rajeev, finding cool videos and then sending them to Ranjeev, without payment.

“We get permission by contacting the owner of the video, via databases of new videos that come from YouTube. Then (we) pay a licensing fee to the licensing company. It’s pretty pricey, around $200 per platform or use.”

Revenue– hopefully - flows from the online views of the YouTube. But Ranjeev observes:

“When posting, it can be difficult to keep posts popular. Sometimes what you expect to get lots of likes and comments is not so well received….”

Ranjeev has been doing the job about a year and loves it. He likes that it is low stress. The hours, working remotely with one person (his boss and the only other person in the company), and the autonomy to watch videos when and how he decides, are all important positives for him.

The only technologically-driven changes he foresees for the job are likely to come from the platforms used to collect and release their online content.

Ranjeev doesn’t see much chance his job will be replaced anytime soon. Finding things that are funny might indeed be a rather uniquely human capability.

Reference

[1] Frey, C. B., & Osborne, M. A. (2017). The future of employment: How susceptible are jobs to computerisation? Technological Forecasting and Social Change, 114, 254–280. https://doi.org/10.1016/j.techfore.2016.08.019

Francis - The Frustrated Academic

"Like tipping weed-killer on a garden": How Centralisation & homogenisation Destroy innovation 

Francis scored his job as 5/10

Francis is a senior lecturer in one of Australia’s higher education institutions, a job that traditionally he has thrived in:  “I love working with ideas, to have them expressed and shared, and influence other people… ideas are important and valuable.”

But, as Francis explains, many organisations don’t know how to cultivate idea production. “When it comes to managing ideas, there’s a bit of a paradox….  Research and ideas by definition are about uncertainty and unknowns, but most of management is about reducing uncertainty through control… Organisations need to allow people to take risks instead of controlling everything”.

To Francis’s frustration, following a trend in the sector, the university has recently restructured in the opposite direction, introducing ever more controlling systems and structures. Such organizational-level changes usually have significant trickle-down consequences for employees’ work design, and that is the case here[].

The first change was centralization, or moving decision-making away from local units to the small senior group in the institution. Although the change was intended to save costs and increase efficiency, the result (common with change of this type) has been to slow decision-making down, often to a stand-point, and to stifle local innovation[1]. In Francis’s words, “centralization is theoretically more efficient, but, when it comes to ideas, it’s like tipping weedkiller on a garden”.  

Francis refers to a second change occurring in the organization as “homogenization” or “wanting every task and metric to be the same across diverse units”. As one example, Francis described how the previously specialist support staff that helped to recruit students for a niche academic program were considered “too expensive” and so were replaced by staff with generalist knowledge. Targeted recruiting techniques, suitable for the specific type of students, were abandoned in favour of one-size-fits-all approaches. The net effect was fewer students recruited, and a lost opportunity for growth. As Francis claimed, “It’s like saying we don’t train surgeons anymore ‘because there is only 50 of them, and we don’t have the adaptability to tailor training to a smaller niche group’ – it just doesn’t make sense as a strategy”.

The organisational redesign affected Francis in several stages. First came bewilderment and shock at the direction of the change. Next came an effort to try to wrestle back some control by taking on a management role. And then, when he realised that – even as a manager - he faced the same blocks to getting things done, Francis gave up and stepped down from the role. And now, in the final stage, Francis is looking to leave the organisation altogether, conforming with research that shows that individuals with scarce skills tend to leave an organisation when they become disengaged[].

Unfortunately, not everyone can so readily escape into a new garden. Francis worries about the colleagues he will leave behind, especially support staff who he sees as “intensely overloaded” by the inadequacies of the restructure:

“The people around me are angry, depressed, upset, but are not able to exit so easily. Also many of them have a belief in a ‘just world’ - they believe their hard work and sacrifice will somehow in the end be recognised and respected. I just don’t think that’s going to happen. And this makes me sad.”

[1] Damanpour, F. (1991). Organizational innovation: A meta-analysis of effects of determinants and moderators. Academy of Management Journal, 34(3), 555-590.

A little more..

What I like about my job.

“To work with ideas, to have them expressed and shared, and influence other people… Ideas are important, valuable”

“Like many academics I don’t think I really like working with students very much… in that they are people, and people are generally draining in some way. It’s not they are not enjoyable, energizing, fun.. But interacting with people is quite effortful. So going from solitary tasks to working with 100s of people is quite demanding...”

Stressors of an academic.

 This isn’t to say it is an easy job. As Francis explained: “The tasks are ill-defined so they can keep going for ever… the research and ideas part of the job especially can’t be contained, so to be successful you have to work pretty much most of the time…”. 

Francis’s view concurs with the research evidence [2,3], which shows that long working hours is a key pressure for academics.

"As a Deputy Vice Chancellor of research once told me, being a successful researcher these days is similar to being an elite athlete – “it’s incredibly competitive”.

[2] Winefield, A.H.; Boyd, C.M.; Saebel, J.; Pignata, S. Job Stress in University Staff: An Australian Research Study; Australian Academic Press: Bowen Hills, Australia, 2008. 

[3] Gillespie, N.A.; Walsh, M.; Winefield, A.H.; Dua, J.; Stough, C. Occupational stress in universities: Staff perceptions of the causes, consequences and moderators of stress. Work & Stress 2001, 15, 53–72.