Noah Stokes comments on GBN about my life threatening encounter with a poorly designed health information technology system (HIT). His thoughts give us second pause to consider seriously the cost in human life for HIT failures. Noah opines that the UK's NHS Programme for IT presents a wonderful vision. I reply, so does the US version. Noah also believes that the "UK now reaps the benefits" of a fully integrated national HIT network. Unfortunately, serious challenges persist with the UK's National Health Service programme for IT at cost and error scale I posited will be true for Mr. Obama's version of an National HIT Network ("Dear Mr. President ...").
Richard Woods ("Darling swings the axe", The Sunday Times, April 12, 2009) wrote, "Or take the grandiose plan to create a central NHS computer system. Originally budgeted at £2.3 billion, it is now expected to cost £12.7 billion. It is years behind schedule, may never work as promised and is seen by many doctors as a waste of money." In an earlier article, The Sunday Times' Jonathan Ungoed-Thomas and Lois Rogers reported their concerns with the massive NHS IT programme ("Focus: Anatomy of a £15bn gamble", April 16, 2009). The issues with NHS' IT programme exist although the IT program is run centrally, therefore, is controllable to reasonable data engineering standards. Contrast the UK's NHS situation with that in the US where HIT is highly fragmented, IT systems are variable within single organizations, and no one authority owns this stuff.
It would be wonderful if HIT could deliver President Obama's, or former PM Tony Blair's, vision. It would also be wonderful if HIT was about "saving lives". Tragically, the opposite is too often true. Poorly implemented HIT can do great harm (e.g., see Drexel University's Medical Informatics Director's, Dr. Scot Silverstein, posts: http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases/).
As IT professionals, we must resist the allure of wealth, prestige, and "solving big problems" when the cost of our exuberance is measurable in human lives. We must, in the case of HIT, proceed as trusted engineers, as builders of the great bridges over which our loved ones drive. We must rationally and soberly assess the HIT challenges we face before we start coding. If we are not up to this challenge, then we have a professional obligation to walk away from the fun and the money. While a national HIT network may someday deliver "life-saving" technology, achieving that vision will be a long, arduous, and expensive journey that requires of IT professionals a renewed emphasis on user interface design and data engineering fundamentals.
I raise even more troubling issues at this link:
http://hcrenewal.blogspot.com/2009/04/upmc-pioneers-in-health-it-or-pioneers.html
Posted by: S Silverstein | April 30, 2009 at 08:26 AM