Getting to the point: developing IT for the sharp end of healthcare

Healthcare demonstrates the same properties of risk, complexity, uncertainty, dynamic change, and time-pressure as other high hazard sectors including aviation, nuclear power generation, the military, and transportation. Unlike those sectors, healthcare has particular traits that make it unique such as wide variability, ad hoc configuration, evanescence, resource constraints, and governmental and professional regulation. While healthcare's blunt (management) end is more easily understood, the sharp (operator) end is more difficult to research the closer one gets to the sharp end's point. Understanding sharp end practice and cognitive work can improve computer-based systems resilience, which is the ability to perform despite change and challenges. Research into actual practice at the sharp end of healthcare will provide the basis to understand how IT can support clinical practice. That understanding can be used to develop computer-based systems that will act as team players, able to support both individual and distributed cognitive work at healthcare's sharp end.