The Softer Side of Health-IT


SYDNEY — Following a hectic week of conventioneering featuring hundreds of posters and presentations — and nearly as many cocktail parties — at MedInfo 2007 in Brisbane, Australia, an eclectic collection of anthropologists, psychologists, sociologists, epidemiologists, and medical informaticists gathered for two days at a Sydney hotel to discuss the “socio-technical” side of health-IT implementation.

“In my world, I am way out there,” said Tip Ghosh, an instructor in health care administration and policy at the University of Nevada, Las Vegas, School of Public Health. He was speaking at the ITHC 2007, the Third International Conference on Information Technology in Health Care: Socio-technical approaches.

“The big thing is that it’s about people,” said Ghosh who believes 80% of health-IT implementation failures are attributed to social and organizational factors. Too many other groups gloss over this reality, he maintains.

“HIMSS is very much focused on business issues,” said Paul Gorman, associate professor of medical informatics and clinical epidemiology at Oregon Health & Science University (Portland), referring to the Healthcare Information and Management Systems Society.

MedInfo, put on every three years by the International Medical Informatics Association (IMIA), is heavy on research and academic approaches to IT in healthcare, as is the work of IMIA’s U.S. affiliate, the American Medical Informatics Association. “I hate to think we’re the poor cousin of MedInfo,” Gorman said last week as he led the closing session of ITHC 2007.

“We are a group of people who are concerned with how the technical and social have to be considered together,” Gorman explained. “A lot of our methods are drawn from and borrowed from anthropology.”

Among the topics discussed at this intimate gathering of about 80 academics and professionals were the role of physicians and nurses as initiators of workflow interruption; healthcare technology for elderly patients; and how to develop health-IT to fit the needs of Generation Y.

“We do need to understand why people interrupt, especially in face-to-face communications,” said Juliana Brixley of the University of Kansas School of Nursing, who presented the paper on interruptions. She cited research from the business world showing that software engineers need 15 minutes to get back to what they had been doing following an interruption. “In our field, we may not have 15 minutes to return to task.”

Another presenter, conference co-convenor Jos Aarts, assistant professor of social medical sciences at Erasmus University Rotterdam in the Netherlands, said that his field has helped researchers learn from IT implementation failures. “Resistance on reporting of failure has come from informatics people,” since their jobs tend to be on the line. But someone with a social sciences background can help draw out this important information, he said.

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