Does technology always make things better?

I recently read a report on the deadly collision of a U.S. warship and commercial tanker in August 2017. The collision resulted in 58 casualties, not to mention millions of dollars of damage, but it was the findings of the report which really drew my interest.

The National Transportation Safety Board (NTSB) concluded that the warship’s navigation system was ‘unnecessarily complex’, with new touchscreen controls in place of traditional, manual throttles. Ultimately, on the day of the tragedy, the complexity of the new system left users unsure how to confidently and accurately control the ship, which subsequently steered into the path of the tanker with tragic consequences.

Interestingly, following the NTSB investigation, the U.S. Navy haven’t decided to modify their training approach, nor the navigation system’s interface. Instead, they’ve decided to ditch the modern system entirely, returning to traditional mechanical controls at a cost of who knows how many millions of dollars.

This got me thinking about the medical device industry where, in recent years, we’ve seen a rush to produce new ‘smart’ or ‘connected’ devices. For example, devices which were once mechanical but are now wholly electronic or with ‘bolt-on’ aftermarket sensors. Such developments aim to improve patient adherence and offer healthcare providers rich patient data to help make better clinical decisions. However, they add complexity; a complexity which, in some cases, has made it harder rather than easier for patients to use the device. A complexity which introduces failure modes that never existed with the original mechanical device.

For example, despite the prevalence of new mechanical and electronic autoinjectors, some of which even connect to an app, there is still a place for the basic syringe and vial in drug delivery. Its simplicity and reliability makes it preferable for many patients, especially in cases where a patient’s physical and cognitive challenges make the simple syringe a safer, more efficient and practical option.

Whilst technological advances can undoubtedly bring great improvements in safety and efficiency, they must be applied in a way that is useful to and usable by the user. In development, we must clearly understand a device’s intended use and users, and then evaluate the most appropriate type of technology. Therefore, rather than adding ‘technology’ to devices for no other reason except that we can, we must first consider the need we are trying to meet and the problem we’re trying to solve.

The head of the U.S. Navy’s ship programme summed this up well when he said, in reference to applying new technology, that “just because you can, doesn’t mean you should”.