Modern doctors - the people are quite advanced to fully realize the importance of introducing information systems to work hospitals. But their expectations from automation are not always adequate - approve the authors of the article. Read more about this below.
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Before talking about disappointments, it is worth saying a few kind words about significant progress in the relations of the heads of medical organizations and doctors with information technologies over the past five to seven years. Now the creation of each new clinic is already difficult to submit without IT-component. This is a kind of standard. The importance of automation is already realized in many medical and preventive institutions.
Especially noticeable recognition of the need for automation when creating commercial medical centers. Any private investor, planning the creation of a separate clinic and even more so the network of medical institutions, immediately lays their equipment to the investment budget.
On the other hand, the overwhelming majority of government medical institutions are either not automated, or practiced patchwork, or rather fragmentary automation. And this is despite the fact that many doctors have long been «no misters» Computer and private order actively use software applications and the Internet.
Despite the low level of automation on average in the health industry, it is quite possible that the psychologically medical community is ready for the mass introduction of information technology. This can be seen, in particular, by the level of awareness of doctors. Unlike a situation of five-seven years ago, if a conversation about medical systems comes, then doctors, as a rule, do not have to clarify what an e-medical card is an integral component of any industrial medical information system.
Where doctors and managers actually became acquainted with the advantages of computer technology, uniform information systems are increasingly becoming the infrastructure ridge of the entire hospital and prophylactic institution - through integration with equipment, through information exchange with other clinics and insurance companies.
Difficulties of introducing information systems to the work of medical institutions
Unfortunately, the introduction of information systems does not always go smoothly. In this regard, medicine is no exception. And in other industries there are many examples of unsuccessful or severe implements that do not bring the desired results by buyers of the system. Difficult implementations are caused by a variety of reasons. Here we would like to stop only some of them. Mainly on the difficulties associated with the wrong expectations of medical organizations when buying an information system.
Of course, there is always a gap between the objective results of the implementation and properties of complex software products, on the one hand, and subjective assessment of these results by the participants in the implementation, on the other. But, it seems one of the main causes of difficult implementations is the wrong ideas and expectations of customers when buying IT solutions.
For example, not all managers clearly realize the difference between a simple office application and a multiplayer system. But if in the first case we are talking about a tool for a separate function performed by one employee, then in the second - about the instrument supporting the work of a whole organization with dozens or hundreds of users. At the same time, often the business processes of this organization are not formalized, that is, not documented and by and large are unknown in all details.
It happens that the management of medical institutions, already adopting a decision on the purchase of a software product, has no idea about ordinary implacing difficulties. Such, for example, as inevitable stress for personnel, painful breaking of stereotypes and, as a result, Sabotage of the new technology.
When during the project, all these problems become obvious, the administration of a medical and prophylactic institution makes some hasty conclusions and is trying to significantly limit the scope of information technology. This may be, for example, a refusal to mandatory use of the system of doctors and the introduction of the implementation of accounting and accounting of services to automation.
Such decisions can be justified by the fact that doctors will have to spend more time to receive the patient if they enable data into the system. Practice shows that in the initial stages, small delays can really take place - people learn, get used to, master new opportunities. But then, as the system is mastered, the productivity of doctors is growing compared to «Paper» Technology.
Hessed rejection of the system functions not only limits individual capabilities, but reduces the effectiveness of implementation in general. Indeed, in complex medical systems, it is the complexity that gives significant advantages compared to patchwork automation. Thus, hasty solutions associated with moral unawareness and ignorance are more destructive than the natural difficulties of developing new technology.
Another typical misunderstanding - the attitude to the accompaniment of information systems. The reason in the same ignorance and misunderstanding of how different levels of difficulty have desktop programs and comprehensive information systems. It happens that the administration of a medical and prophylactic institution not only does not recognize the need and importance of technical support of the system by developers, but also does not recognize the usefulness of the internal IT service. Although even one competent specialist in the state of the clinic can remove many problems of operation of the system and stabilize the conditions for normal users.
The internal IT service of the customer is not a luxury, but a guarantee of stability and development. Thinking by automation, not all medical facilities look into the future. Not everyone is aware that after the introduction of the system, when people feel new opportunities, life is not lit in place, but will move on. Evolve the needs of users and the organization as a whole.
Another extreme is an attempt by some medical and preventive institutions to make a comprehensive system on their own. The leaders who have decided to go this way usually lead two simple arguments. First that our own development will allow you to automate important features, competitive advantages of the clinic. Secondly, their programmers will do everything much cheaper than the external contractor.
Even if you recognize that in some cases, these considerations may be justified, it is important to understand the associated limitations and, most importantly, the final price of the decision. Automation of competitive advantages, of course, a worthy task. But what proportion makes specific business processes in the total volume of medical institution functions? There may be 5, 10, in extreme cases 20%, hardly more. Meanwhile, if it is decided to do the remaining 80-95% at home, then all the features of internal development will apply to them.
What is this features? They are especially pronounced with the very accelerated development that supporters «home» Software leads as a second argument «per» homemade system. This is speed and low cost. The desire to do everything as quickly can almost always turns into a violation of the architectural integrity of the system and the refusal of planning and documenting work. And it turns out not only custom, but also technical documentation.
Is it worth explaining what it turns around when new requirements for the system and the need to make changes! Universally homemade systems also experience serious difficulties with connecting complex medical equipment. As a result, no speed is ensured, but the illusion of the development speed. Since fragmentary successes should, as a rule, the period of actually negative performance in the development. Figuratively speaking «rave». In the language of the project of project management, this situation is described as a combination of high risks and high cost of ownership of the system.
Usually medical institutions are prone only to one of two extremes. Either live at all without IT service or try to write their system. But there are such cases when one decisions are first taken, and then diametrically opposed. The organization makes two, three attempts to start all over again, leaves the finished decision to its own development and then returns back.
It is impossible to say that independent developers are not accustomed to these dramatic stories. Unfortunately, the customer has very serious grounds for replacing the once selected software product. Often it happens due to excessive product rigidity, its inability to follow changes in the work of the organization. Another typical sin of developers is the unsatisfactory formulation of the implementation process, which, however, is a problem for the entire Russian market of integrated information systems.
Inadequate and overwhelmed expectations associated with insufficient awareness are manifested not only in the underestimation of the difficulties of introducing or an overestimated assessment of internal development prospects. Another common error - some exaggeration of automation opportunities as such. Let's say, at the current stage of development, it is not yet necessary to talk about full-fledged decision-making systems that would supply doctors with useful intellectual prompts for all occasions. Although in the future, perhaps in the near future, such functions will certainly appear. At least in serious, industrial systems.
Basically, the two most common misconceptions are overwhelmed expectations in terms and idea of the implementation of the system as a finite process. Sometimes suppliers expect that the introduction will be rapid, almost instantaneous. It is also implied that with the installation of the system all the troubles will stay behind. About how difficult the installation of systems is connected, we have already said above. Successful overcoming of these difficulties is possible only with a sober calculation of temporary and personnel resources: without hot and hatching.
As for the completion of implementation, it is also not superfluous to repeat the idea of the continuous evolution of the system requirements. Of course, in each introduction you need to draw a line. The set of functions claimed by the supplier must be implemented. But then, when experts are aware of all disrupting opportunities, user appetites grow and work on the development of the product continues. And this means new implementations, new problems and new achievements.
