Sunday, January 13, 2008

Complex Hospital Information Systems (HISs)

This is one of a series of blogs on hospital information technology, emphasizing limitations and pitfalls.

The following is a short excerpt from Biomedical Informatics.

Beginning of excerpt:

Much can be learned from documented technology disasters. A 2003 article in the British Medical Journal described a project to install a computerized integrated hospital information system in Limpopo (Northern) Province of South Africa (1). This poor province with 42 hospitals had invested heavily to acquire the system. This fascinating article describes what went wrong and provides a list of factors that led to the failure of the system. this included a failure to take into account the social and cultural milieu in which the system would be used. There was an underestimation of the complexity the undertaking and insufficient appreciation of the length of training required by the hospital staff.

Failed system implementations occur in the U.S. The Veterans Administration spent hundreds of millions of dollars on a financial tracking system. The software implementation failed during trials at the Bay Pines VA in Tampa Bay Florida. Plans for extending the system to other VA hospitals became the subject of Congressional hearings (2).

End of excerpt

When an IT disaster occurs at a major medical center, there is a tendency to hush up the news. I have been told, in confidence, of other expensive systems that failed to implement or that implemented in a way that most users considered unsatisfactory. My perception is that HIS disasters are actually common, but I have no way of proving it.

There are many blogs in which health IT problems are openly discussed. Two of these are are:


1. Littlejohns P, Wyatt JC, Garvican L. Evaluating computerised health information systems: hard lessons still to be learnt British Medical Journal 326:860-863, April 19, 2003.
2. Untangling the VA computer crash: How Bay Pines hospital went from guinea pig to paralyzed victim because of pressure to implement a new system. St. Petersburg Times Tampa Bay. March 28, 2004. Comment. The Veterans Administration spent nearly $500 million on a failed computer system.

-Jules Berman
My book, Principles of Big Data: Preparing, Sharing, and Analyzing Complex Information was published in 2013 by Morgan Kaufmann.

I urge you to explore my book. Google books has prepared a generous preview of the book contents. If you like the book, please request your librarian to purchase a copy of this book for your library or reading room.

tags: big data, metadata, data preparation, data analytics, data repurposing, datamining, data mining