Many people who have entered the healthcare sector in recent years have asked me, and others, a similar question. Indeed it was the pursuit of an answer to this question that led me to found Sláinte Healthcare (now Vitro Software). The question is simple;

When the world is awash with technology and most sectors have operated electronically for many years, why is it, that the main information recorded in healthcare is still on a paper chart? That despite investment in expensive IT solutions, patient safety is reliant on clinicians being able to read other clinicians’ writing and access pieces of paper?

The answer is that healthcare is different, and does not function like a regular industry. This is both an explanation and an indictment. Let’s start with the fact that it is an indictment.

In a large number of industries, technology is utilised to extract the maximum amount of quality and efficiency for the lowest long-term cost. Think of financial trading, where automated algorithms are tuned to execute trades in milliseconds. Think of manufacturing, where sophisticated design applications coupled with production automation has led us into a new era of high-quality, low cost products.

However important it is to have high-quality devices & gadgets, the rationale to apply technology to drive efficiency and quality in healthcare is overwhelming. The consequences of success or failure in the delivery of the service are profound. The fact that technology has not been used to its full extent is as a result, an indictment of our healthcare model.

We do need to note that IT projects do fail in other industries, and there are many areas of industry which have not availed of technology-driven efficiency and quality improvement, but in general these are due to a lack of competition in those markets and so the indictment mentioned above stands.

Healthcare is also different in another way – how its organisations are designed and how its key people work. A typical corporate worker spends a lot of time either at a desk or in close proximity to his/her laptop – over time there has been an assumption that they cannot work without it. In healthcare, the key players – nurses and doctors – spend most of their time away from computers, making their adoption of electronic medical records more difficult.

Even if they were to access a computer, there is usually a barrier. To most, it appears that spending valuable time punching information into a difficult-to-use computer system is a waste, and without any discernible benefit to them or their patients. Due to the fact that hospitals and health systems do not operate as corporations, there is rarely a situation where the organisation can insist on data-entry compliance.

The result is one of two things – a minimal amount of data is recorded to the medical record, leaving out information, including nuances during observation that doctors look to when assessing a case, or a high-degree of friction, and subsequent IT implementation failure due to lack of alignment on policy.

Unfortunately that is where the bulk of healthcare still resides. My humble view is that we need to realise that medical wards are not finance departments and stop assuming that they will work with computers in the same manner. In order for technology adoption to be pervasive in healthcare systems there needs to be change;

• Be simple to use and implement so that clinicians will want to use it.
• Be able to support changes in how clinicians operate at very short notice.
• Be accessible on easy-to-carry mobile devices.
• And be able to handle losing connectivity, and keep working.

Not a lot to ask is it?