Introduction:   Organizational and human factors issues associated with healthcare IT have led to project difficulties and failures.  Detailed case accounts might improve knowledge sharing between healthcare organizations on lessons learned and best implementation practices. Web-based, detailed information on healthcare and other IT project difficulty that can be used as “lessons learned” by others in their own projects is uncommon.  With the increasing push for EMR implementation at national levels, knowledge sharing via the Web on project difficulties might be helpful to those involved in design and implementation.  In clinical medicine and indeed in any scientific field, you cannot just count the hits and ignore the misses.

Industry bias tends towards sharing information on successes and publishing little about failures, combined with a notable blindness to the healthcare IT industry’s own methodological shortcomings.  For example, the Scottsdale Institute, a corporation founded in 1993 serving CIOs and executive teams in top healthcare systems, cites itself as an organization where “healthcare industry leaders can learn to improve performance by sharing successes.”  It also states that “solutions for key healthcare issues are far-reaching; they involve comprehensive culture change, process redesign and significant tool and IT investment.”  The culture change and process redesign, however, refer to issues within healthcare, not within the IT sector itself.  In IT, culture change and enlightened thinking about the appropriateness of the rigid methodological doctrines of business computing for clinical settings are also essential, as I believe business computing and clinical computing are different subspecialties of computing.

We believe filling the information gap on healthcare IT difficulties is an essential goal to which medical informatics specialists can contribute, and that doing so would be helpful to patients and the healthcare community.

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