Ergonomics and Your Practice: Physical Risks of Technology

The explosive growth of computing and mobile devices has been both a boon and a burden for healthcare.  Anytime, anywhere access to patient information is a great thing, albeit one that comes at with potentially high hidden physical costs. 

Indeed prolonged improper use of computing devices can cause physical harm unless ergonomic risks are addressed.   As just one example, the OSHA Safety Pays Program estimates the direct cost of carpal tunnel syndrome at $30,000, with indirect costs and impact (e.g., lost productivity / time away from the job, etc.) doubling that.   

You're likely aware of these risks - heck, you may treat patients with these issues!  But just like there may be a prevalence of unhealthy sweets and treats in medical practice break rooms, we don't always practice what we preach.  The start of a new year is a great time to reset priorities and take steps improve the ergonomics of your office. 

Start with the obvious: your office may not have been designed with digital devices in mind.  Ideally, the budget for any new technology implementation will include funds for evaluating the office environment and making optimal changes needed to minimize ergonomic risks.  However, technology is too often shoehorned into already crowded work spaces, setting the stage for ergonomic injuries.  Moreover, with so many other urgent priorities in modern medical practices, discussion and actions to stem ergonomic issues may arise too late, when someone comes forward with chronic pain or injury.

Even without the budget for a substantial remodel, you can educate yourself on best practices for using technology, make small impactful changes to the office environment and educate staff for healthier computing. 

OSHA provides a convenient "eTool" for evaluating and improving computer workstations (https://www.osha.gov/SLTC/etools/computerworkstations/)   This Lifehacker article is a very readable summary of solid recommendations for how to ergonomically optimize your workplace  .

One thing you'll quickly notice is that the recommendations are primarily centered on traditional desktop PCs.  However the sales of traditional desktop PCs have been declining for several years, with laptops, convertible devices and tablets selling in far greater numbers.  Today's laptops are miracles of sleek mobility.  But the designs we love present issues for prolonged, regular use, with compact (i.e., cramped) keyboards, small, often glossy (i.e., eye-straining) screens fixed an inch or so above the keyboard.  Tablets, because of their still smaller size and various modes of use also have risks.

Once you've refreshed your commitment to reducing risks, here are some basic steps to take:

• Analyze workflow routines and the environment where devices are used.  You may find awkwardly placed monitors, keyboards, or peripherals in at the front desk, back office, or patient care areas.

• Use a consultant who can help you not only identify ergonomic issues, but is also familiar with a wide variety of products you otherwise of which you might not be aware.

• Laptops are sometimes used as a "cheat" in cramped areas or are set on surfaces too low (or high) for comfortable use. Consider minor changes to improve their ergonomics (e.g., elevate a laptop for proper screen height and use and external keyboard to reduce strain.)  Also look at other choices such as adjustable wall mounts, keyboard floats, or rolling carts or tables for laptops.

• Talk with staff as you examine your office: educate them about ergonomic risks and encourage them to speak up if they're having a problem. 

• Design for devices with multiple users - chairs, keyboard floats, and even wall mounts should be easily adjustable if needed.

• Consider alternates such as specialized medical voice recognition software (e.g., Dragon Medical.)  If you had a bad experience with these products in the past: look at them again as they've dramatically improved in recent years.  Informal training or mentoring of new users can go a long way to ensure adoption and use of this technology, and you'll likely find it improves productivity as well.

Above all, don't be afraid you'll be "opening a can of worms" by bringing up the topic of workplace ergonomics.  Sure, some providers or staff may use this as an opportunity to complain.  But given the risks - and costs- of ergonomic injuries, raising the topic and discussing possible solutions is an important step.  And it will also let them know you want to keep them as healthy, productive members of your team.

A Few Resources:

OSHA Computer Workstation eTool: https://www.osha.gov/SLTC/etools/computerworkstations/

Top 10 Tips for Healthier Tablet use: http://www.ergonomicsblog.uk/tablet/

OSHA Safety Pays Program: https://www.osha.gov/dcsp/smallbusiness/safetypays/estimator_text.html#indirect