It has finally happened, I have transitioned to viewing myself as a widget, a depersonalized interface between the EMR and the patient. I am the unnamed device that collects the patient data and subsequently transcribes it into prose for billing purposes and maybe the occasional colleague review. There is a bit of curious comfort in identifying myself as a mere cog. I’m imagining I will now fly below the radar, undetected by Administration, and able to complete tasks despite missing the mark on necessary RVUs. I will aim to move invisibly and emotionlessly through the day without being asked too many questions or given many tasks. Oh, I bet I could make a game of this!

I’m wondering if you are familiar with the inner workings of a Dr. Widget. There is a particular shape to this style of gadget. When seated, the motherboard of the contraption is tilted slightly forward, with its grips moving across a keyboard while words simultaneously appear on the computer screen set before it. There is something mechanical, yet eerily human, about the device. Every once in a while, it rises from its chair and interfaces with a patient.

Previously coded questions come in a brief barrage from a facial orifice, and then a verbal summary is offered to the patient. Amazingly enough, this contraption has been programmed to offer a nod and smile to the patient before departure. Widget 1.0, the pre-pandemic version, was able to perform a physical examination and handshake, but those functions were deemed unnecessary in the update. It is theorized that the next version will no longer require a chair and be completely housed in a CPU (computerized physician unit). The current Dr. Widget still requires some maintenance, including occasional refilling with H2O and emptying a muscular bladder that holds the filtered water. Interestingly enough, the orifice on its front face can also continuously take in candy, gum, and coffee without seizing up. Fascinating!

Most widget units are located in large health care centers and perform sub-specialized functions, such as administration of anesthesia, reading of imaging studies, and surgery. But, the base unit always comes with the needed EMR interface, which is viewed as the widget’s primary function. There was a recent report from a large medical center that a group of widgets became senescent and began to resist mandates from the administration to improve efficiency. Application updates were made immediately by sending secure emails containing negative displacement threats. Thankfully this messaging slowed the network’s mounting energy and reversed the exponential acceleration such that the Laws of Nature were not violated. Brilliant!

So far, Dr. Widgets are not available for individual purchase, but it will only be a matter of time before this is the case. Some health care centers currently allow 24-hour patient access to their widgets. Convenience for the patient supersedes any maintenance needs of the contraption. There are mounting reports of burnout among widgets that have been run continuously. Unfortunately, motor replacement is not an option for a broken unit, so a newer model widget is the next strategy. The cost to the health care system for a basic widget can be as high as $300 to 500K, and for a specialized unit, as high as one million. Excessive!

Mandates are requiring these professional devices to improve clinic efficiency, see more patients, complete all documentation in a timely fashion, maintain appropriate network connections, continuously update internal files, and avoid burning out because it’s hard to reboot.

Hey! Like any computerized widget, I, too, have a maximum signal transmission speed and can only process limited numbers of inputs at any one time. With more mandates and requests come additional decisions. More choices mean it takes longer to make a decision (Hick’s Law.) Inevitably, my processing and output will slow, and multitasking is already humanly impossible. What fixes are there for this Dr. Widget conundrum? Unfortunately, it seems lengthy update efforts must occur within each unit through individualized programming. The following viable but unverified upgrade algorithms may help:

1. Shut down programs running in the background by closing the office door.
2. Turn off low-power mode by inputting liquid and solid sustenance.
3. Take time to output all liquids and solids when an impulse signal is received from central processing.
3. Get proper ventilation by seeking nature.
4. Manage random access memory by pausing to refocus every 20 minutes (Pomodoro Technique).
4. Free up space on the hard drive by deep breathing, meditating, listening to music, and stretching.
5. Improve WiFi signaling by connecting with others.
6. Or, do as this Dr. Widget is going to do, unplug and go offline!

Susan MacLellan-Tobert is a pediatric cardiologist and can be reached at Health Edge Coaching.