New Clinician-Controlled Composable Approaches to Health IT

Abstract

Healthcare is highly specialized extremely complex area in which technology for the future must accommodate practices and evolving needs which include knowledge from 2000 years ago and yesterday's new diseases. It poses special problems for the design of software, because of the complexity, high-stakes high-pressure nature of the work, the large variability in patients, doctors and nurses, specialties, and institutions, and the needs for privacy, security, and rapid change. This has resulted in major protests by doctors and nurses in some countries due to the poor usability and lack of fitness for purpose of much healthcare software. We discuss different approaches which may help solve some of these problems by creating a technology platform giving more control to the healthcare provider and integrating the many new information sources which must now be considered, including data from mobile devices and sensors. The effects of having modular composable platforms controlled by the doctor or nurse can include improved efficiency, fit to task, cognitive support, and the ability to evolve the system continuously to meet new needs, emergency conditions (such as the Ebola outbreak) and new variations in health systems. We discuss research findings from this approach as well as new directions.