Thursday, March 25, 2010

First Order Retrieval

As a society, we are surrounded by technology.  Some more than others. Currently, I have in my direct possession an iPhone, and iPod touch, this laptop, a calculator watch and a USB drive.  That's just on my person. Devices designed to connect me to others, to simplify my life, to make information more accessible.

All of the technology out there and what do we do with it? Instead of simplifying, we clutter. Disregarding the iPod touch (it's a leftover from my transition to the iPhone) I still have three devices on my person that have essentially overlapping functions.  My USB drive and watch (see photo) have functions easily reproduced by my iPhone, which is itself a more portable and compact version of the laptop on which I am composing this entry.

While organizationally, this is not intuitive, there is some method to my madness.  A few months ago I saw a video of Mythbuster Adam Savage (to whom I have occasionally been compared) iterating his belief on "first order retrievability."  In essence, any object (in Adam's case, his tools) that is of use should only be one level removed from the user. For example, if I want to know the time, I simply have to glance at my watch. That's first order retrievability. For the iPhone/iPod, I have to tap the power or home button. Technically, that's second order, but this is arguable. For my laptop, I'd have to turn it on, log in, and wait for the OS to load. More wasted time, less effect. In most workplaces, and especially medicine, this inefficiency reigns.

The sane person is thinking right now, "If you take this to its extreme endpoint, you'd have a million gadgets just to get through the day." And they'd be right. To an extent. The beauty of tech, and specifically most of our newest tech, is the ability for most devices to take on the characteristics of another device with first order retrieval. For instance, I tap an icon and my iPhone becomes a GPS. Another button and it's a web browser. Yet another and it's a camera. While none of these functions compare to their standalone counterparts, they're "good enough for government work."

As a physician, this is immeasurably useful. I have finite time, finite pocket space and a limited number of slots on my "bat belt." With a smartphone, and a multitool (Gerber FliK) I can have an relatively infinite number of tools at my disposal. My iPhone acts as a PDA, phone, camera and GPS at its bare minimum. With the right collection of Apps, I have a complete medical library, tools for measurement and recording, even an entire Electronic Medical Record, all in a single device. 

For a doctor, first order retrievability allows you to spend more time with patients and less time looking for things. Even if finding a chart only takes 15 seconds, multiply that by the 30 patients a day most doctors see and you're talking minutes. A quick and dirty estimate (I timed myself walking 15 feet, searched through an alphabetized list and selected an item, then walked back) reveals that it's more like 2 minutes. That's an hour a day. In busy offices, that's 4-5 more patients.  Or even better, 2 extra minutes with each patient.  Even if you pay someone else to do the job, that's still "person hours" being used for information retrieval that could be done in milliseconds by a "gadget."Add in all of the other third and fourth order retrieval tasks we encounter throughout the day, and the benefits of a first-order retrieval system are obvious.

It's not an easy proposition, but it's well worth it in the long run.

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