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Automation When work processes are sufficiently routinized, they can be automated. You can probably think of medical technologies that help health professionals do things they couldn't otherwise do. Such a technology benefits professionals and patients because it's skill-enhancing. But technologies that automate work are usually deskilling or skill-degrading because they're designed to serve management by tightening its control of employees. Much health information technology is skill-degrading. As the work of health professionals becomes increasingly automated, they lose the ability to do their jobs without HIT. To make matters worse, they're expected to keep pace with machines. They serve the machines rather than doing the more gratifying work of patient care, and ultimately they're compensated less well. 5. DiSplAceMent Employers would prefer not to have to control employees. It's too much trouble. Machines are technically efficient, and they don't join labor unions. From an employer's point of view, the ideal workplace would be one where machines did all the work. Of course, in all industries, there are still many jobs performed by people rather than machines, but employers automate whatever processes they can. For health professionals, as for other employees, losing skills is a stage on the way to being replaced by machines. Displacement is hard to spot because it's unlikely to appear as a one-toone correspondence; that is, you probably won't find a robot sitting in your colleague's chair tomorrow. It's more likely to happen piecemeal, over an extended period, and through attrition. • The job of patient care will be redefined, privileging technical over clinical skills. • The hospital will begin to hire more HIT specialists and fewer RNs. • Functions performed in the past by health professionals will be fragmented and reallocated between machines and less-skilled employees. • Increased technical efficiency will enable the hospital or HMO to expand without expanding its workforce. In any business, increasing productivity—that is, getting more work out of each employee—means displacing employees. Farming machinery has displaced family farmers, robots have displaced autoworkers, ATMs have displaced bank tellers, and scanners have displaced grocery checkers. A trend toward displacement is clear in the changes in any industry viewed in historical perspective. Because employers decide how company money is invested, these five functions have been selling points for countless workplace technologies for more than 200 years. They're also built into health information technology. © Copyright IHSP 2009. All rights reserved. Doe s y m a n ag e o u r you to r want f a cus to ollow s e r vi c e m e r scrip t? II pe at haphe ns h W when trk netwo s? c r a s he H o w a re patients assessed in telemedicine? w a s th e W h en e y o u las t tim d e visitteller? a bank