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Healthcare IT will not fix broken health processes

operating.jpgThose of you who have been visiting regularly will know this topic is a hobby horse of mine. Often, healthcare finds an operational problem, and instead of addressing it by changing human activity (which is difficult) it decides to buy a computer (which is easy) hoping that it will sort everything out. Invariably the IT makes matters worse or creates a new set of problems.

For an example of IT in action, please read this account on HHN Most Wired of a man who took his son with meningitis to a US hospital: “A Patient's View of Health IT”.

Now, of course, there is no excuse for poor customer service. Healthcare in UK is different from that in the US, and, in the main, I have had few problems with it. Most of my irritation is caused by long waiting times and administrative processes that often seem to be for the benefit of staff rather than the patient.

However, I guess what I should be concerned about is outcome. After all, poor processes and old-fashioned buildings are much less important than a first-class outcome. The National Patient Safety Agency in the UK in “Right Patient, Right Care” (PDF) identified a 10 percent mismatch between required and delivered treatment for the UK's annual 8m inpatients.

Is that mismatch symptomatic of broken processes? And, if it is, will the deployment of the National Programme for IT's (NPfIT) information systems make them better or worse? I remember reading this on a poster in an office:

“We all make mistakes that's very true indeed,
But to really mess things up a computer's what you need.”

Shouldn't we address the real problem before implementing the IT?


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Spot on Colin: find the problem, then identify IT as the best solution. Or not.

On the other hand isn't some of this a bit like building motorways - you should build them before you need them; then when you have them you find new things you can do?


Yet another good question.

I am a believer in planning beneficial changes to human systems (including medical practice, if needed) *and* then finding/designing the IT to support them.

However, you are right. Once implemented users usually find new ways to innovate and then outgrow the IT and so it goes on. Inevitable I suppose.

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