Pediatric Informatics: Computer Applications in Child Health (Health ...

8 Complexity in Healthcare Information Technology Systems 101
user-friendly process modification capabilities. Health IT is a rapidly advancing,
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interdisciplinary informatics research and development area.
8.3.3 Pediatric Health IT Implementation:
Learning from Each Other
We are only beginning to understand the complex interrelationship between human
factors and technology. Even though it is more difficult to publically discuss failures
than successes, it is incumbent upon centers who have implemented pediatric
CPOE to thoroughly define the human factors and workflow processes that predict
success or failure and to report their experiences. In Pediatric Informatics, we must
learn from each other, and from our failures and successes. The Seattle group had
the benefit of visiting Pittsburgh before beginning their own CPOE implementation.
That visit provided valuable and explicit lessons, especially for identifying
stumbling points that can hamper smooth implementations. One of the fundamental
problems faced by Children’s Hospital Pittsburg was the inefficient “stat” ordering
of urgent, life saving therapies. Life-threatening events, where seconds count, are
a daily occurrence in all hospitals and must be addressed by CPOE implementers.
Often times, Health IT systems are not flexible enough to deal with these emergency
situations. Hospital based implementation teams must assure that “breakthe-glass”
functionality is available to users that allows them override system
deficiencies in critical care situations.
Armed with real world observational and experiential data, Seattle Children’s
was able to navigate the workflow, communication, socio-technical challenges
of their commercial CPOE with less difficulty than their predecessors. Through
continued communication and collaboration, hospitals will continue to learn from
prior implementations and vendors will improve commercial products for children.
The aggregate effort will increasingly improve the positive safety profile of inpatient
Pediatrics.
A roadmap outline of the specific problem elements that contributed to the divergent
results in the “Tale of Two PICUs” is summarized in Table 8.3.
8.3.4 Information Technology and Complexity
in Pediatric Care Environments
The following paragraphs discuss the challenges that the combination of existing
complexities in Pediatric care environments and the introduction of health
IT solutions can generate. The list of issues discussed here is by no means exhaustive,
it is meant only to allow users to reflect on the complexity and unforeseen problems
encountered by teams attempting to implement information technologies.