Health Information Systems: Searching the Past – Finding a Future
Hosted by the London School of Economics on 18 April 2012, the 12th Social Study of ICT workshop (SSIT12) looked at the past and the future of Healthcare Information Technology (HIT). The workshop series is organised by the Information Systems and Innovation Group.
The keynote speakers focused on such questions as “how helpful is information technology for patients, practice, or payers?” and “the important role of ‘open’”. Both speakers, Ross Koppel, University of Pennsylvania, and Bill Aylward, Moorfields Eye Hospital NHS Trust, highlighted the problem of closed systems and the feeling of being held hostage by HIT vendors.
Ross Koppel gave a lot of examples of bad UI design of healthcare information systems with sometimes deadly consequences, e.g., when the dosage is calculated wrongly. He showed how people work around software issues with again sometimes bad consequences for patients. Bill Aylward then focused on ideas of openness and transparency in open source development and bug tracking as a way of dealing with quality issues. Developers and HIT users are often very far apart during software development. Open Eyes shows how to bring them closer together in an open source project.
For Bill Aylward HIT should be more like air traffic control software with problem-focussed user interfaces and swift response times. HIT instead has its data all over the place which requires its users to wait 2-6 minutes in average for just opening a patient record. His vision: an ecosystem of apps like on iOS devices such as the iPhone where data is shared but apps are independent.
The other speakers explored the “consequences of using electronic patient records in diverse clinical settings” (Maryam Ficociello, Simon Fraser University), viewed “evaluation as a multi-ontological endeavour” (Ela Klecun, LSE), and took us on a “Journey to DOR: A Retro Science-Fiction Story on researching ePrescribing” (Valentina Lichtner, City University). The last session closed with talks on ”Real People, Novel Futures, Durable Presents” (Margunn Aanestad, University of Oslo) and ”Awaiting an Information Revolution” (Amir Takian, Brunel University).
The speakers provided lots of evidence for the need of software that can explain (at least some of) the design rationale of the software engineer in order to bridge the gap between software engineer and user. Bringing them together like in the Open Eyes project is one way of dealing with the issue. But not all users can be included in the development. New users will not know about the design rationale and will not have access to the respective software engineers. This is where explanation-aware software design (EASD) comes into play. EASD aims at making software systems smarter in interactions with their users by providing such information as background information, justifications, provenance information.