Remember When?

The other day I was reflecting on a few things about how things used to be; the one TV channel, no internet, no smart phones (or mobile phones at all), no ATMs and getting cash from the bank on Friday afternoon for the weekend (either that, or find a nice person to cash a cheque for you). There were the “remember whens?” of the postie’s whistle telling you there was mail in your letterbox, and the clink of the milk bottles at the gate in the late afternoon (and trying to protect your milk money from the local teenagers …).

I have no doubt that there will come a time in the not too distant future when we will ask; “remember when you were given plastic bags at the supermarket, and when we drove cars that ran on fossil fuels?”. 

In health care and clinical service delivery, do you remember when we provided clinical care with little or no reference to evidence-based practice? Or when instruments weren’t disposable, or when we had to store tons of x-ray film, or when a cholecystectomy required a three week hospital stay? 

This has led me to wonder - what will be our 'remember whens' in ten years time?

Perhaps we will ask; “remember when?”;

• we couldn’t access our own health records whenever we wanted or needed to?
• we all thought that our own particular hospital ward / specialty / organisation / information system / clinic was so special and somehow needed to be different and not particularly efficient or integrated with other services or systems?
• people had to make multiple appointments at multiple sites or clinics and had to somehow fit in with them all?
• we got a diagnosis from a real, breathing person and not an online programme running on an artificial intelligence database?
• we had to go to a lab to get blood taken off (with needles!), so that tests could be run and information sent to a doctor to assist with our care or support diagnosis?  
• we didn't have non-invasive real time monitoring of vital signs and baseline blood measurements that fed continuously into your health system's clinical record?

There are many more possibilities than this short list.  But they’re not all positive. We can but hope that we never have to ask the question; “remember when we had antibiotics that worked, and people didn’t die from relatively minor infections?”.

Looking forward and considering which ‘remember whens?’ we might ask gives us the opportunity to time travel and look back, to see things through different eyes and consider the context and the challenge of the view.

Maybe it’s a valid way of assisting us to progress.  Defined projects help us move forward by pushing us to achieve objectives according to a plan.  My point is that sometimes we might need a view from the future to assist us to define the objectives and the strategy – getting our future selves to help direct us to that future, and not a ‘default’ one.

What’s a default future?  Default futures are what happen when you don’t plan. They happen as you scramble to respond to things you didn’t anticipate.