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Why Technology Fails

November 19, 2010
by Pete Rivera
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What healthcare can learn from the new TSA screeners

Going through Logan Airport yesterday gave me an opportunity to experience firsthand the new Back Scatter X-Ray technology. The technology was first introduced as a way of quickly evaluating passengers (in an unobtrusive way) to determine if they were concealing any weapons. The public was concerned that the images were going to be too revealing and that there would be excessive X-Ray exposure. TSA responded by moving the X-Ray viewer away from the screening area. They also added additional processes as part of the system.

So let me explain what it was like. I took off my shoes and put my laptop on a bin. Then the TSA agent announced that all belts and jewelry needed to be removed. So I shuffled in my socks, holding up my pants and placed both feet on a corresponding mark. The agent then told me to raise my hands above my head. I wanted to suck in my gut so I would not look really bad on the scanner picture, but I knew my pants would fall to the ground. In just a few seconds, I was told to proceed. But I was not cleared yet. The TSA agent had to wait for a radio call from the remote operator to confirm that the image did not reveal anything scary (besides my gut). He then asked me if I had anything in my left pocket, I said no. He asked me about my back pockets. Well of course I have my wallet in my back pocket. He asked me to remove my wallet and he proceeded to look inside checking for who knows what. Then he informed me that he would have to do a pat down. A few more minutes passed and we were on a first name basis. I will spare you the details of how he conducted the search. Finally, the TSA Agent asked me to bring my palms up as another agent conducted a swab test. Apparently, using a wallet means that you must be transporting some dangerous device. A few minutes later I was told that I can proceed. I was not sure of the social protocol at that point, if the agent should thank me, or if I should thank the agent. I just walked away amazed that the process was so cumbersome.

The reason this technology will fail is not because the device is failing the initial requirements, it’s because the process that was married to the technology makes it cumbersome. How many times have we seen a healthcare system that was purchased to solve specific pain points? The RFP goes in, the ROI is identified and everyone expects a quick win. But during design the management team starts chasing other areas and pain points. The technology initiative is used to justify adding new processes and then the software is customized to meet other requirements not on the initial scope. The project team gets excited since they will be improving on the initial use of the system. But when the switch is turned on, the end users scream that the old system was much easier to use and took less steps. Sound familiar?

We are often so eager to install a new system that we lose sight of what will happen on Go-live. I like to subscribe to the premise that you need to crawl before you walk and before you run. I don’t think the TSA has figured out that what started as a way to be less intrusive, has evolved into the most intrusive process short of medical exam.



Pete: There are many reasons I decided to start my own business. Forced travel was clearly in my top 5. Even after I launched my search practice I still needed to meet face to face with candidates which meant more travel. Today we use technology to eliminate much of the stress associated with travel and dealing w/ the TSA. Your story brings back lots of memories of when I used to travel over 100,000 miles a year. Some of my travel memories are wonderful. None of my experiences with the TSA are memorable. Not a single one.

I can understand the rationale for having TSA, and I think in general we are safer than before. But I think we all knew that when the Government took over the screening, that procedures would be put in place that would not make sense and we could not argue against.
The other scary parallel is when the Government takes an even more active roll in Healthcare..but don't get me started there...

Pete, That was a fun and interesting read. Thank you. You can thank me later.

A quick story that further makes your point. In 2007, my sister suddenly and unexpectedly passed away. She lived near the west coast, I'm on the east, and I needed to grab a one-way, last minute flight to deal with the aftermath. My plane tickets were visibly covered with large warning text and other marking that I have not seen before or since. And, since I live near Washington DC, the airport had procedures to pass me through multiple scanners before my interrogation. Fortunately, I had that single-minded sense of ultimate purpose that I simply went with it. But, to your point, there was no process, married to the technology that was sensitive to my predicament.