Growing up in a family immersed in healthcare, Thomas Goetz says he made the conscious decision to follow a different path, becoming a journalist and serving as executive editor of Wired magazine for several years before his current stint as entrepreneur in residence at the Robert Wood Johnson Foundation.

A few decades ago, he says he began to see how technology could help improve healthcare. “In the past, technology had always been an expensive burden in the healthcare environment,” he says. “We’re at a different moment right now.”

That moment, however complicated by uncertainty about the future landscape, is also challenged by the struggle between hardware (which includes such things as the building or the furniture) and software solutions (meaning the people, emotions, and experience).

“Healthcare thinks too much about hardware and not enough about software," he says.

During his opening keynote at the Healthcare Design Conference, Goetz gave some examples of existing struggles, including devices versus applications; data versus knowledge; and patients versus people.

When he turned to the discussion of E-boards versus whiteboards, Goetz said whiteboards are cool in Silicon Valley, “but not in a hospital.”

To prove his point, he showed images (many taken clandestinely) of various whiteboards in use in healthcare facilities: Mostly messy units, some strewn with tape and ink stains, and so ubiquitous “you don’t notice them.”

“It makes you think there’s got to be a better way,” he says.

A trip to the ER, however, gave him another perspective as he watched nurses and staff members gathering around these pieces of equipment. “It wasn’t just a place to put information,” he says. “When people talk in front of a white board, information is exchanged.

“I want to make sure we’re not throwing away something that’s a vital tool,” he says.

In another example, he discussed noise levels in a facility and how the average level of background noise in a hospital is 70-80 decibels and can sometimes reach as high as 100 decibels. A lot of that noise comes from equipment and devices that are great in alerting the staff when something’s wrong but are prone to false alarms.

The problem, he says, is that the answer is often a “hardware solution”—turning off the equipment or silencing or ignoring the beeps—rather than looking at adjusting how it works, such as sending alarm notices via pagers rather than beeping noises in the patient rooms or nurses’ stations.

In the big picture context of healthcare design, Goetz says the future should involve more opportunities to look for these types of solutions.

“The soft stuff can be elusive,” he says. “But if we can get a grasp on it, we can make some change.”