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Enrico Coiera1, Jos Aarts, Casimir Kulikowski

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Summary
This summary is machine-generated.

Increased use of information and communication technology (ICT) in healthcare presents significant safety challenges. Addressing these requires common standards, better development, and user training to mitigate potential harms from complex systems.

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Area of Science:

  • Health Informatics
  • System Safety Engineering
  • Digital Health Transformation

Background:

  • Healthcare systems are rapidly increasing their deployment of information and communication technology (ICT).
  • Current ICT integration in healthcare mirrors the aviation industry's safety challenges from the 1950s.
  • The scale and complexity of health ICT systems are expanding from regional to national and supranational levels.

Purpose of the Study:

  • To highlight the escalating risks associated with widespread ICT adoption in healthcare.
  • To identify factors influencing the increase or decrease of ICT-related harm in health systems.
  • To underscore the challenges in mitigating these harms due to organizational inertia.

Main Methods:

  • Analysis of current trends in health ICT deployment and system complexity.
  • Comparison of health system safety maturity to historical benchmarks in other industries (e.g., aviation).
  • Identification of key factors contributing to and mitigating ICT-related harm.

Main Results:

  • Despite potential for harm reduction, increased ICT use will lead to a higher absolute number of ICT-related harms.
  • Factors promoting safety include common standards, technological maturity, improved development, testing, implementation, and user training.
  • Factors increasing harm include system complexity, heterogeneity, rapid implementation, and inadequate user training.

Conclusions:

  • Mitigating ICT-related harm in healthcare is a complex challenge requiring proactive strategies.
  • Organizational inertia may create a lag in harm reduction efforts, similar to hysteresis.
  • A multi-faceted approach focusing on standards, development, implementation, and training is crucial for enhancing health system safety.