A case against arbitrary field size limits in Medical Records

Here's my IT perspective on The Doctor vs. the Computer, which appeared in today's New York Times.

The doctor in question hit an arbitrarily sized text field for inputing the evaluation of a patient, and was arbitrarily stopped at 1000 characters. The help desk confirmed the limit, and was snarky about it.

I can see how this may have been an acceptable design decision when systems had a total of 5 megabytes of space in the 1960s, but it is clearly not acceptable by any means in our current era.

I found the article via Quora, and here's the comment I wrote there:

Wow... I can see how such things happen... and that is a truly stupid situation. Hours of lost medical care to save a few megabyte of disk space across a year. 

A single photograph, let alone some MRI or CT scan data could wipe this savings out in an instant. 

The savings in this case, assuming the doctor had 5000 characters of text, would be 4000 bytes... and at today's prices of about 10 Gigabytes / $US, that works out to 0.00004 cents. Let's say it took 2 minutes to do the edit. 

Done 10,000 times per year, that's 13.8 days of medical staff time, to save a whopping 0.04 cents! 

Yikes!

Now... I'm cross posting it here to reach a wider audience. If you're in IT, and considering the size limits of a text field, be very sure you don't just want a memo field instead.


Thanks for your time and attention.