ICTs and healthcare research: Putting the user first
The implementation, diffusion and integration of new information and communication technologies (ICT’s) across health care organizations raises numerous social, organizational and clinical issues. In an environment in which healthcare services increasingly are being managed in accordance with private sector norms and practices, the delivery of healthcare often is seen as being inefficient. For example, in Canada, hospitals account for almost one-third of the country’s national healthcare expenditures (CIHI, 2007). In the light of this situation, particular attention often is given to the supposed labour productivity and other economic benefits to be gained by the widespread implementation of ICTs across the healthcare sector.
According to received wisdom, these technologies offer a means of reducing the costs of healthcare delivery as well as fundamentally transforming the diagnosis and treatment of illnesses. The core idea here is that the implementation of ICTs will facilitate information sharing across healthcare organizations thereby enabling physicians and other healthcare providers to see more patients more quickly without reducing the quality of care provided. We suggest, however, that the preoccupation with employing ICTs to enhance the efficiency of healthcare organizations is all too frequently linked to an overly simplistic and rather deterministic understanding of the factors influencing the success and failures associated with the implementation of information systems in organizational contexts.
The emerging research in the telemedicine and telecare domain suggests a few preliminary conclusions about the impact of ICTs on the delivery of healthcare. On the one hand, the increased flow of information facilitated by these technologies is, broadly speaking, enabling healthcare professionals to become more efficient in terms of making informed clinical decisions more quickly (Bonneville and Grosjean, 2007). On the other hand, however, a number of studies also have shown that the implementation and diffusion of ICTs across the healthcare sector is negatively affecting the quality of care provided (Bonneville, 2007, Grosjean and Bonneville, 2006). For example, Bonneville and Grosjean (2007) found that problems with technical infrastructures (e.g. computer bugs, IT maintenance-related issues, lack of technical support) frequently impede the ability of healthcare professionals to successfully carry out their clinical routines. Moreover, Bonneville and Grosjean’s findings suggest that large numbers of healthcare professionals do not know how, and have no desire to invest the time/resources needed, to make effective use of healthcare-related information systems.
Taken together, these findings raise a number of questions about the compatibility of the techno-economic logic driving the expansion of ICT-based healthcare with the provision of high quality patient care. More importantly they highlight the need to not lose sight of the complex interplay of factors influencing the delivery of patient care. Put simply, and as we have argued elsewhere, there is a continued need for ICT-related healthcare policy to be guided by empirical evidence about the compendium of factors influencing success and failure of ICT implementation and diffusion in the telemedicine and telecare domain as opposed to abstract assessments of technological potential. It is only on the basis of such user-centred evidence that we can expect to formulate successful strategies for improving efficiency of healthcare delivery in a manner that does not diminish the clinical and therapeutic dimension of healthcare performance.
|Authors :||Luc Bonneville, Ph.D., Associate Professor
Department of Communication
University of Ottawa
Daniel J. Paré, Ph.D., Associate Professor
Department of Communication
University of Ottawa
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