Confronting The Paradox Of Information Technology In Healthv2
Information Revolution in Health: The Paradox Starvation in the midst of plenty! NSW ACHSM Dinner and IBM Executive HealthCare Dinner Professor Steven C. Boyages CE Clinical Education and Training Institute November 2010
Definition• Paradox -n• 1. a seemingly absurd or self-contradictory statement that is or may be true: religious truths are often expressed in paradox• 2. a self-contradictory proposition, such as I always tell lies• 3. a person or thing exhibiting apparently contradictory characteristics• 4. an opinion that conflicts with common belief[C16: from Late Latin paradoxum, from Greek paradoxos opposed to existing notions, from para- 1 + doxa opinion]
Challenges to the health systemRising Demand Constrained Capacity – Growing & ageing – Patient Safety population – Chronic illness rising – Workforce shortages and – High levels smoking, attitudes obesity, stress – Manage demand within – High consumer finite resources expectations – Cost vs investment – High key Worker Expectations – NSW spends about 28% of budget on health care Needs – 1.3 million dollars per hour technology demography 3
“Process changes, like a new computer systemor the use of a checklist, may help a bit,” hesaid, “but if they are not embedded in asystem in which the providers are engaged insafety efforts, educated about how to identifysafety hazards and fix them, and have a cultureof strong communication and teamwork,progress may be painfully slow.”
Investing In Health IT perceived as a solution to some of these challengesBenefits Risks Improved automation Financial investment not realised Improved productivity Poor connectivity Reduced duplication Lack of common standards Improved safety Increased risk to patients Improved patient and staff experience Increased staff frustration and lower morale Improved reach of information and service Staff expectations not realised Poor execution and implementation due to inadequate training 5
Why is it so?Have we overestimated the benefits?Have we underestimated the complexity of the task?Have we procured the wrong products or systems?Have we had poor direction?Have we started at the wrong place?
• Hype• Failure to understand the complexity of workflow• Poor Connectedness and Interoperability• Systems are not yet agile and flexible• Need for integrated e- government strategy
Technology Paradox of Personal Life and Work Complex Work systems Spot the Difference
Close to 450 million users sought access to the Internet through mobile devices this year, IDC said. That number could grow as Internet- capable mobile phones, smartphones and other wireless devices become affordable.The number of mobile Internet users will growas the number of worldwide Internet usersincreases. A total of 1.6 billion people accessedthe Internet this year, and the number couldreach over 2.2 billion users in 2013. More than1.6 billion devices, including mobile devices,PCs and gaming consoles, were used to accessthe Internet this year, and that number couldtop 2.7 billion by 2013.
Disconnect in School Slide Courtesy of Cisco, Australia13
WorkflowCompetency Procurement and Governanceand Training ImplementationFunctionality Connectivity Standards IT system Improved Improved reach Improved Improved Reduced Improved patient and of informationautomation productivity duplication safety staff experience and service
Figure 12Source: The Lancet (DOI:10.1016/S0140-6736(10)61854-5)Terms and Conditions
The Fly Wheel of Health• Competency • Collaboration• Culture • Capital • Care Models Workforce Capacity Needs Demand• Equity • Demography• Social • Chronic Care Determinants Technology is the Accelerator