Anchorage, Alaska is home to a health care organization that qualifies as something of a medical miracle. The Southcentral Foundation (SCF) is tiny compared to giant hospitals in the Lower 48. But the scale of its challenges is truly vast. It serves a geographical area larger than the state of Texas, including both Alaska’s biggest city and remote villages accessible only by boat or plane.
Under the leadership of CEO Katherine Gottlieb, it has transformed itself from one of the most trouble-plagued health care operations in the country 20 years ago to one of the most exceptional today. The Harvard Medical School published a case study on it; executives from as far away as Singapore and New Zealand have trekked to Anchorage to see it for themselves; and Gottlieb became the first Alaskan to receive a MacArthur Foundation “genius” grant.
What are the secrets of SCF’s success? Visiting executives and researchers (including me) learn many lessons, but the most important revolve around its focus on patients, doctors, and nurses as human beings. When Gottlieb took over the struggling system, “I knew I was going to change everything,” she told me. “Everything. But first and foremost, we knew that people deserved to be treated like people.”
This flies in the face of the current digital obsessions of the health care field. Consider surgeon Atul Gawande’s recent New Yorker account of the $1.6-billion decision by Partners HealthCare, the famed Boston hospital system, to deploy new medical software, a comprehensive data-tracking system called Epic. Here’s how Gawande described his reaction to the software: “I’ve come to feel that a system that promised to increase my mastery over my work has, instead, increased my work’s mastery over me.”
Sound familiar? In industry after industry, field after field, we seem to be applying software systems at the expense of individual autonomy and professional flexibility.
I’m not just talking about the millions of young people (and adults) who are essentially addicted to social media. And I’m not just talking about 24/7 email culture, which means wherever we are, we are always at work. I’m talking about how, in our drive for enhanced productivity and more consistent processes, we have allowed the design constraints of our computer systems to constrain our freedom to engage with customers, solve problems that are out of the ordinary, and otherwise recognize the nuances that define business and life—nuances that elude the rules-based logic of billion-dollar software implementations.
During exams, for example, doctors at Partners and around the country may spend as much time looking at their screens as making eye contact with patients. Back in the office, doctors spend countless time inputting data, in the (laudable) interest of letting fellow doctors access their findings. The end result of this rampant digitization, Gawande reports, is “epidemic levels of burnout” among doctors. And it’s not just doctors. “As digitization spreads,” he notes, “nurses and other health-care professionals are feeling similar effects from being screen-bound.”
Thousands of miles away, SCF shows that it doesn’t have to be this way. Its human-centered principles shape every aspect of how the system operates, from the design of its facilities to its embrace of integrated-care teams to meet the complex needs of patients, to its commitment to train the entire staff, even dental assistants, in how to recognize the warning signs of addiction, depression, or domestic abuse. At the same time, SCF is no Luddite: it makes aggressive use of technology, especially telemedicine, which allows it to reach far-away villages, but all of its technology is designed to amplify its commitment to humanity.
“They are so thoughtful about treating people as real human beings,” says researcher and consultant Cory Sevin, a nurse practitioner at the Institute for Healthcare Improvement who has advised medical systems of all sizes. “They have done an amazing job of deep listening… [and] serving people the way they want to be served rather than what’s most convenient for the system.”
Meanwhile, back in Boston, Gawande concludes: “Something’s gone terribly wrong. Doctors are among the most technology-avid people in society…Yet somehow we’ve reached a point where people in the medical profession actively, viscerally, volubly hate their computers.”
In an era when organizations are being reshaped so profoundly by technology, what colleagues and customers remain hungry for, and what we are at risk of losing, is a deeper and more authentic sense of humanity. This is a problem for Silicon Valley executives, who have to reckon with the “techlash” that is sweeping business culture. It’s a problem for investors, who have to figure out the limits of automation, artificial intelligence, and other risky bets on substituting computers for people.
It’s also a problem for technologists themselves, who both unleash and agonize over the ever-widening role of software in the workplace. One website aimed at computer professionals wrestled with the issue of “Why Everyone Hates the IT Department,” and its explanations would sound familiar to Gawande. On a discussion board for up-and-coming programmers, one developer wrote a post titled, “I’m Starting to Hate Working with Computers,” and complained that I “can almost feel myself getting more and more detached from reality.”
It’s extreme to suggest that executives and investors face either-or choices between betting on technology or betting on people, between becoming more efficient or more human. But it’s not extreme to suggest that unless we all pay more attention to tech-fueled tensions, more and more of us will hate our computers.