Resistance to computer innovation

Abstract

Dr. Lawrence Weed's "knowledge coupling" (KC) computer innovation (Weed, 1991; 1997; 2000) is designed to overcome the widely documented limitations of the human mind. By linking (or "coupling") patient-specific findings with relevant medical knowledge, KC tools exploit the power of the computer to reliably recall, process, and organize vast quantities of medical knowledge and information that would otherwise be missed during the clinical encounter. Further, KC tools offer an alternative strategy for managing clinical uncertainty, which also entails relinquishing personal responsibility for patients and decision making. Previously-learned orientations toward uncertainty and responsibility predispose physicians to resist this alternative strategy. Existing orientations are sustained by the broader institutional framework medicine. Nonetheless, changes in the institutional framework --- namely, greater patient participation in decision making and growing interest among third-parties to regulate medical care costs and quality --- will likely make it more difficult to sustain current orientations to clinical practice and will instead produce conditions that are more favorable to the widespread use of KC tools.