From the Editor

From the Editors: Your call is important to us


There they were – dropping like a stone toward the lunar surface some 48 years ago. Buzz Aldrin looked at his onboard computer and it reported Error 1202, and alarms started going off in the Lunar Module. Fortunately for Neil Armstrong and Buzz Aldrin, they had a healthy relationship with their computer systems and IT support. Mission control was only 1.5 seconds away and had a huge team of experts that told them they could ignore the error message. The rest is, of course, history. Human beings, not computer software, landed the Eagle. They used their own judgment and experience and data provided by the computer to make their landing decisions.

The Eagle Lunar Module, Apollo 11 mission, 1969 NASA

The Eagle Lunar Module, Apollo 11 mission, 1969

Imagine an alternative history. Mission Control uses one software system (think tertiary hospital) and Eagle (think where you work) uses a different one. The two systems are not interoperable (they don’t talk to each other). Buzz up at the moon has to scan in his password, the mission number, and date/time every time he wants data to give to Neil who is actually flying Eagle (think of Neil as a surgeon concentrating on a critical aspect of a patient’s care). Error 1202 comes up on the display at 50,000 feet above the lunar surface. Buzz doesn’t know what that code is and his onboard flight manual doesn’t say (it is written in a dense computer format not amenable to human comprehension). He calls up Mission Control. Sorry, all flight directors are busy with other missions, please hold. He is “fourth” in line. Please do not hang up.

At 25,000 feet Mission Control answers. Buzz describes the error code. Mission Control reports that his computer is made by Grumman and that Mission Control uses Lockheed-based software. He is advised to call the Grumman help line. At 15,000 feet Grumman responds. They report that Buzz’s password expired about the time the lunar descent burn occurred. He needs to put in a new password and confirm it. He will receive a confirmation email within the next 24 hours. Neil is getting increasingly restive despite his famously bland emotional responses in crises.

At 10,000 feet Buzz gets a new password confirmation, but Error 1202 remains on the display. The moon is enormous in the windshield. Grumman support responds that the error is likely because Buzz put in the wrong weight for the Lunar Module. Buzz begins again feeding in the data to the onboard computer. Grumman suggests that had Buzz simply created the right template, this problem would not have occurred. Buzz, through gritted teeth, asks how he was supposed to create a template for a problem that no one seemed to expect.

They are down to 150 feet now. Neil tells Buzz what he thinks of the computer systems and is told by Mission Control his microphone is hot and that such comments are not appropriate. At Mission Control, a notation is made on their system that Neil will need to discuss this pilot error with the astronaut office upon his return. Neil simply turns off the onboard computer and lands the Lunar Module with seconds of fuel left as he avoids a large boulder field and finds just the right spot. Tranquility Base reports in to Mission Control. Mankind has landed on the Moon.

The alternative history is what surgeons are experiencing every day because of the unhealthy relationship existing between American health care today and our institutional computer systems. Like Neil and Buzz, these surgeons are heroes who avoid boulder fields despite so many obstacles unrelated to their missions. No wonder burnout (a missile term) is so prevalent. We’ve gone from inconvenient to intolerable. Our health care computer systems must be interoperable to have any meaningful use. Our formats need to be understandable. Surgeons need computers to help them make judgments based on easily accessible data in real time. Surgeons need to “fly” the missions and computer systems need to be our servants, not our masters.

Dr. Tyler G. Hughes, clinical professor in the department of surgery and director of medical education at the Kansas University School of Medicine, Salina Campus

Dr. Tyler G. Hughes

Dr. Hughes is clinical professor in the department of surgery and director of medical education at the Kansas University School of Medicine, Salina Campus, and Co-Editor of ACS Surgery News.

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