This blog is contributed by guest author, Dr. Malcolm Thatcher.
I have spent my entire working life in the IT profession. In the earlier part of my career I designed, built and implemented enterprise systems for Finance and HR/Payroll, Supply Chain systems, Energy and Mining systems, Policing and Legal Aid systems, and Agricultural systems (to name a few). Without doubt, these systems had varying degrees of complexity but none of them compared to the systems I was involved in when I entered healthcare in the second half of my career.
As a CIO in large health systems, both public and private, and in my federal role with the Australian Digital Health Agency, I had oversight of implementing more clinical systems than I care to count. Outside of my executive roles, I have also been a full-time Professor of Digital Practice and undertaken significant reviews on behalf of governments in Australia.
Unique Challenges of IT in Healthcare
Throughout my 20 years in healthcare, there is one thing that stands out as differentiating the healthcare sector from other sectors I have worked in – and that is the human impact of technology in healthcare. Healthcare is a sector where seconds matter. Timely access to information by clinicians is critical and therefore performance of clinical systems and networks is critical to patient outcomes and the overall efficiency of delivering care.
The Complexity of Implementing Clinical Systems
Healthcare professionals, including clinicians and administrative staff are inextricably bound by a desire to heal and help those who are often facing some of life’s greatest challenges. I have had the privilege of working in hospitals for many years, experiencing firsthand the tribulations of both patients and staff.
Implementing technology solutions, particularly those involving major disruption or transformation of clinical workflows, is challenging. Let me elaborate…
- Clinical systems nearly always require localisation and configuration. Such configurations, particularly relating to complex clinical workflows are perfectly imperfect, i.e. they rely on clinicians to interact with software ‘experts’ to build these workflows and rarely is the result anywhere near perfect. Often the workflows need ongoing tweaking and refinement over a long period. This understandably results in frustration for clinicians.
- The clinical workforce has varying degrees of digital competency. For example, asking a nurse for the first time to use an electronic medical record (EMR) to undertake nursing assessments, charting and administering medications can be terrifying when they’ve spent their careers caring for people and not always learning technology. The time taken to become proficient in the use of these systems is often viewed as taking away from time spent with patients.
- Many hospitals still manage hybrid records. While many Australian hospitals have ventured into the world of paperless EMRs, many still have not and need to deal with the hybrid nature of both digital and paper medical records. Beyond EMRs and other specialist clinical information systems, clinicians are faced with a rapidly evolving digital health landscape including the integration of AI into decision-making and advancements in personalised medicine – both of which are challenging the traditional roles of clinicians.
Key Technical Factors in System Performance
Whilst technology in healthcare is here to stay, clinicians will often echo common sentiments regarding the need for the technology to ‘just work’. No doubt we have all experienced the frustration of technology not working or not behaving as usual, which we otherwise take for granted. Imagine time-poor clinicians’ frustrations when they are being blocked in their work by slow or non-functioning software.
Throughout my experience implementing clinical information systems, I would say the most common criticism I faced from clinicians was that systems were too slow, too many clicks, too much time waiting. For a clinician, every second counts. A clinician waiting while the spinning wheel of disappointment cycles on the screen, does not endear them to the software, no matter how clever the software.
There are of course many technical components that contribute to the performance of end-user software, from network routing / latency to database performance, to application complexity and data integrations, not to mention the performance of end-point devices being used to access the software.
Why Observability is Critical in Healthcare IT
Ensuring observability across all components is increasingly vital for meeting users’ expectations of enterprise software. In the past, effective observability and digital experience optimization tools were limited or inadequate, but that is no longer true. Today, scalable and affordable solutions exist for optimizing network and application performance, managing digital experiences, proactively detecting and resolving issues, and providing comprehensive, end-to-end monitoring and management of enterprise systems. Organizations now have no justification for neglecting these investments, especially in critical fields like healthcare, where every minute counts in patient care, and where both clinician and patient experiences should be optimized to the highest standard.
Dr. Thatcher is CEO and Founder of Strategance Group, a firm specialising in digital strategy, risk and governance services to assist organisations with their digital investments. Dr.Thatcher is a published author and has held senior executive roles in large public sector and private sector organisations. Notable roles included Chief Technology Officer of the Australian Digital Health Agency, Chief Health Information Officer for Queensland Health; CEO of eHealth Queensland; and Chief Information Officer and Executive Director Facilities for the Mater Health Group. Dr. Thatcher was also formerly a Professor of Digital Practice in the QUT Graduate School of Business.