The Algorithm Will See You Now

Abstract

For decades, eliminating preventable error has been presented as an audacious, responsible, even noble goal for healthcare organizations. Bosk proposed to show the folly of this aspiration. This essay moves Bosk's work forward by placing ideas about reducing error in the context of other attempts to routinize work, on the one hand, and casting doubt of the viability of such programs, on the other. Other scholars have reshaped our understanding of human behavior by revising key assumptions to make them more psychologically and sociologically realistic. Using Simon's revision of global rationality and Kahneman's revision of expected utility theory as examples, this essay takes a first stab at suggesting which assumptions of the preventable error paradigm need revising. Because we do not fully understand how we gather and process information about each other, this essay argues that we should preserve opportunities for more holistic information gathering, both by ethnographers and medical staff. Importantly, those include occasions when medical workers (not algorithms) encounter, observe, and listen to patients as full human beings (not their digital twins).