Health IT Success and Failure: Recommendations from Literature and an AMIA Workshop

Abstract

With the United States joining other countries in national efforts to reap the many benefits that use of health information technology can bring for health care quality and savings, sobering reports recall the complexity and difficulties of implementing even smaller-scale systems. Despite best practice research that identified success factors for health information technology projects, a majority, in some sense, still fail. Similar problems plague a variety of different kinds of applications, and have done so for many years. Ten AMIA working groups sponsored a workshop at the AMIA Fall 2006 Symposium. It was entitled "Avoiding The F-Word: IT Project Morbidity, Mortality, and Immortality" and focused on this under-addressed problem. PARTICIPANTS discussed communication, workflow, and quality; the complexity of information technology undertakings; the need to integrate all aspects of projects, work environments, and regulatory and policy requirements; and the difficulty of getting all the parts and participants in harmony. While recognizing that there still are technical issues related to functionality and interoperability, discussion affirmed the emerging consensus that problems are due to sociological, cultural, and financial issues, and hence are more managerial than technical. Participants drew on lessons from experience and research in identifying important issues, action items, and recommendations to address the following: what "success" and "failure" mean, what contributes to making successful or unsuccessful systems, how to use failure as an enhanced learning opportunity for continued improvement, how system successes or failures should be studied, and what AMIA should do to enhance opportunities for successes. The workshop laid out a research agenda and recommended action items, reflecting the conviction that AMIA members and AMIA as an organization can take a leadership role to make projects more practical and likely to succeed in health care settings.

Guest editorial for special section on success and failure in software engineering

“…That is, many studies measure success in terms of meeting schedules, budgets and requirements. Of the three papers that mention the Iron Triangle, Atkinson (1999) and Kaplan et al (2009) reject it as oversimplified and inappropriate.…”

Decision time for clinical decision support systems

“…Electronic health records, eprescribing and digital medical imaging are well known to clinicians and have been implemented with varying degrees of success. 1 In addition, clinicians increasingly make use of online repositories such as PubMed and Google Scholar, 2 and specialised search engines such as FindZebra 3 to help answer clinical questions. One often overlooked set of IT tools are clinical decision support systems (CDSSs), which have been defi ned as systems that 'provide clinicians or patients with computer-generated clinical knowledge and patient-related information, intelligently fi ltered or presented at appropriate times, to enhance patient care'.…”

Acceso y uso de las tecnologías de información y comunicación y percepciones hacia un sistema informático para mejorar la adherencia al tratamiento, en médicos endocrinólogos de un hospital público de Perú.

“…El fracaso de los sistemas de información en salud no es un evento infrecuente y la mayoría de literatura disponible que documenta diversos problemas -tanto técnicos como sociológicos, culturales, y financierosprovienen de países desarrollados (6)(7)(8)(9). En Perú, son escasos los estudios publicados que reportan la evaluación de sistemas de información en salud (10).…”