Thinking about technology in health care brings to mind Charles Dickens: "It was the best of times, it was the worst of times." Technology in health care today ranges from cutting edge to archaic. We have superb diagnostic equipment, but still can't get lab results on the chart in a timely fashion.

We have surgery suites with high-tech robotic, voice-activated equipment waiting for patients or doctors who can't be found. I continue to be baffled at seeing companies such as Federal Express and UPS, which know where any of their millions of packages are at any given time anywhere in the world, and seeing hospitals that cannot keep track of their patients and lab specimens.

Bring up the topic of technology in a group of health care professionals and it's likely that half will groan and tell you a horror story of their last technological implementation and the other half will get starry-eyed and tell you all the wonderful things that their newest technology does. Both groups, however, will tell you that they have learned a lot about what works and what doesn't in the development and implementation of technology.

We've learned that it's far easier to apply technology to diagnostics and equipment than to processes that involve people. Why? Because people have variability and are not as predictable. Take as an example the computerization of nurses' schedules that has been a long-sought, but not easily achieved goal. As far advanced as artificial intelligence is, it has not yet been able to consistently "learn" all the nuances (competencies, experience, personal needs and desires, etc.) that must be considered when developing a schedule that will work.

We've discovered the hard way that technology is a facilitator, not a magic bullet, and that it cannot be implemented in isolation. Developing and implementing strategies that effectively integrate and use the technology are as important as signing the purchase order for the technology itself. Nothing kills the potential of new technology faster than skimping on the training of the people who will use it. We've also learned that not obtaining user input from development to implementation and beyond almost guarantees little to no chance of the technology being successful.

In adding the "high touch" component to the "high tech," we've found that the technology that allows us to get closer to our patients often has as great an impact-although different-as the technology that advances the science of medicine. The two together can be a powerful resource. One example is in obstetrics, where we combine the high-tech equipment in a delivery room with the technological capability to transmit a picture of a minutes-old baby to grandparents who live across the country.

Technology is not a panacea, but it gives us a way to continually improve the care we deliver and the way in which we deliver it. Nurses are well-positioned to create new and better technology, as well as to assist in the development of technology created by others. Our ability to observe and diagnose situations and processes and to find creative solutions is just what's needed to develop technology that makes our jobs easier and improves the care of our patients.