Revision [226]
Last edited on 2010-05-20 02:59:08 by MartinWehlouAdditions:
Since the specifications are designed by the IT departments, and the negotiations with the vendors are also done by the IT department, the ultimate choice of system will be something that is primarily intended to keep the IT department budget within bounds. If that involves having less functionality for the ultimate users, that is not something the IT department is aware of. It also has no incentive to find out.
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Revision [225]
Edited on 2010-05-20 02:49:16 by MartinWehlouAdditions:
Naturally, if the specifications are designed by the IT departments, and the negotiations with the vendors are also done by the IT department, one cannot expect the ultimate choice of system to be anything that is not primarily intended to keep the IT department budget within bounds. If that involves having less functionality for the ultimate users, that is not something the IT department is aware of, and has no incentive to find out.
Deletions:
Revision [224]
Edited on 2010-05-20 02:48:20 by MartinWehlouDeletions:
Revision [223]
Edited on 2010-05-20 02:46:49 by MartinWehlouAdditions:
The result is a policy of specifying and purchasing almost exclusively large all-in-one solutions with an absolute minimum of standards-based interfaces for other systems. What the IT departments hope to gain is the elimination of the need of smaller solutions. The all-in-one systems even promises an almost total inability to usefully integrate smaller systems, which absolves the IT department from even trying. This is all very attractive to a budget conscious IT department without a clear incentive to support health-care use of IT beyond the simple and mundane.
Deletions:
The all-in-one systems even promises an almost total inability to usefully integrate smaller systems, which absolves the IT department from even trying. This is all very attractive to a budget conscious IT department without a clear incentive to support health-care use of IT beyond the simple and mundane.
Revision [222]
Edited on 2010-05-20 02:46:30 by MartinWehlouAdditions:
The result is a policy of specifying and purchasing almost exclusively large all-in-one solutions with an absolute minimum of standards-based interfaces for other systems. What the IT departments hope to gain is the elimination of the need of smaller solutions.
The all-in-one systems even promises an almost total inability to usefully integrate smaller systems, which absolves the IT department from even trying. This is all very attractive to a budget conscious IT department without a clear incentive to support health-care use of IT beyond the simple and mundane.
The all-in-one systems even promises an almost total inability to usefully integrate smaller systems, which absolves the IT department from even trying. This is all very attractive to a budget conscious IT department without a clear incentive to support health-care use of IT beyond the simple and mundane.
Deletions:
Revision [221]
Edited on 2010-05-20 02:44:13 by MartinWehlouAdditions:
The result is a policy of specifying and purchasing almost exclusively large all-in-one solutions with an absolute minimum of standards-based interfaces for other systems. What the IT departments hope to gain is the elimination of the need of smaller solutions, and even stronger, the ability of smaller systems to be usefully integrated with a larger all-in-one solution.
Deletions:
Revision [220]
Edited on 2010-05-20 02:37:38 by MartinWehlouAdditions:
Current electronic health-care systems are built as monoliths. They are constructed and sold as all-in-one solutions, largely because of the failure of care provider organizations to successfully manage collections of smaller, more specialized systems. This failure is caused by two factors:
- The failure of the smaller vendors to cooperate and produce simple methods of supporting each other's need for interconnection
- The failure of IT departments at health-care institutions to actively seek out and support such best-of-breed solutions
The result is a policy of specifying and purchasing almost exclusively large all-in-one solutions with an absolute minimum of standardsbased interfaces for other systems. What the IT departments hope to gain is the elimination of the need of smaller solutions, and even stronger, the ability of smaller systems to be usefully integrated with a larger all-in-one solution.
- The failure of the smaller vendors to cooperate and produce simple methods of supporting each other's need for interconnection
- The failure of IT departments at health-care institutions to actively seek out and support such best-of-breed solutions
The result is a policy of specifying and purchasing almost exclusively large all-in-one solutions with an absolute minimum of standardsbased interfaces for other systems. What the IT departments hope to gain is the elimination of the need of smaller solutions, and even stronger, the ability of smaller systems to be usefully integrated with a larger all-in-one solution.
Deletions:
Revision [219]
Edited on 2010-05-20 02:30:31 by MartinWehlouAdditions:
Current electronic health-care systems are built as monoliths. They are constructed and sold as all-in-one solutions, largely because of the failure of care provider organizations to successfully manage collections of smaller, more specialized systems. This failure is not caused by the care providers, but by the failure of vendors to produce smaller, best of breed solutions that effectively work together, opening the market for these all-in-one systems that can only be called "worst-of-breed". There simply is no way that one vendor can be a specialist in each and every area that a large electronic health-care system covers and that is painfully noticeable when you have to work with them. For the vendors, it's expedient to construct these large systems without any standard couplings to other smaller systems. Additionally, there is no business case for allowing smaller systems to connect, since what these vendors are selling to the health-care organizations is mainly a one-stop-shop solution, promising simplicity in the management of the IT department. What they are //not// selling is deeper and more flexible health-care solutions, but that usually isn't part of the requirements either.
Naturally, if the specifications are designed by the IT departments, and the negotiations with the vendors are also done by the IT department, one cannot expect the ultimate choice of system to be anything that is not primarily intended to make life easier for the IT department. If that involves having less functionality for the ultimate users, that is not something the IT department is aware of, and has no incentive to find out.
What appears to us as a problem of closed interfaces is then rooted in a deeper problem, namely that closed interfaces is exactly what the current IT departments wish for. First and foremost, they do not wish to have any open feature that enables the medical departments to ask for, and possibly get, the smaller best-of-breed systems they need for clinical care, since it would often involve committing more resources for IT configuration and support.
Ultimately, this is a problem of priorities. Currently, savings of IT department resources are clearly prioritized above the needs for better IT support on the floor. I find it very hard to believe that the savings achieved in the IT departments of our health-care institutions, if any, is anywhere near the cost to health-care in the form of delayed diagnoses, increased pain and suffering, and increased insurance costs. As long as the authorities let IT departments scrimp on medical IT support by specifying solutions that inhibits any attempts at improving health-care IT beyond what the all-in-one vendor deigns to produce, we will not be able to improve health-care by better IT use. This is basically a political problem.
Naturally, if the specifications are designed by the IT departments, and the negotiations with the vendors are also done by the IT department, one cannot expect the ultimate choice of system to be anything that is not primarily intended to make life easier for the IT department. If that involves having less functionality for the ultimate users, that is not something the IT department is aware of, and has no incentive to find out.
What appears to us as a problem of closed interfaces is then rooted in a deeper problem, namely that closed interfaces is exactly what the current IT departments wish for. First and foremost, they do not wish to have any open feature that enables the medical departments to ask for, and possibly get, the smaller best-of-breed systems they need for clinical care, since it would often involve committing more resources for IT configuration and support.
Ultimately, this is a problem of priorities. Currently, savings of IT department resources are clearly prioritized above the needs for better IT support on the floor. I find it very hard to believe that the savings achieved in the IT departments of our health-care institutions, if any, is anywhere near the cost to health-care in the form of delayed diagnoses, increased pain and suffering, and increased insurance costs. As long as the authorities let IT departments scrimp on medical IT support by specifying solutions that inhibits any attempts at improving health-care IT beyond what the all-in-one vendor deigns to produce, we will not be able to improve health-care by better IT use. This is basically a political problem.
