The preceding stories represent suboptimal use of resources, intellectual capital, high cost of lost opportunity, and risk to patients and to the well-being of healthcare organizations. The people in these stories all note a "metaproblem": the difficulty bringing the obvious problems to the attention of senior healthcare leadership, and be heard and have significant action taken. Politics is commonly one of the problems, although just as frequently the reported problems are not well-comprehended.
That it is very difficult to have such problems dealt with decisively speaks to a weakness in current healthcare leadership structures. That these stories are apparently commonplace should be troubling to all who think critically. The individuals currently charged with planning and implementation of healthcare information technology, in particular healthcare executives and CIO's, must accept an authoritative role for clinicians and informaticists in healthcare IT decisions. In addition, when executives are made aware of problems with clinical IT by clinicians and informaticists, they need to see, look, listen, and pay very careful attention to the messages. Once given information on the problems, they should turn to the clinical informatics specialists and allow them to address the problems in a collaborative manner.
In summary, clinicians and informaticists need much stronger authority in clinical computing. A system where critical decisionmaking about clinical IT is made by executives who may be unqualified must evolve and become more appropriate to patient care needs.
This site calls for such changes in healthcare, consistent with the compassionate patient advocacy traditions of the medical profession. Please direct comments to me at the email address on this site’s homepage.