Technological innovations, opportunities, and challenges




One of the rapidly growing areas of health care innovation lies in the advanced use of data science and machine learning. The key opportunities here are:

  • health monitoring and diagnosis
  • medical treatment and patient care
  • pharmaceutical research and development
  • clinic performance optimization

Handwritten reports or notes, manual order entry, non-standard abbreviations and poor legibility lead to substantial errors and injuries, according to the Institute of Medicine (2000) report. The follow-up IOM (2004) report, Crossing the quality chasm: A new health system for the 21st century, advised rapid adoption of electronic patient records, electronic medication ordering, with computer- and internet-based information systems to support clinical decisions. However, many system implementations have experienced costly failures. Furthermore, there is evidence that CPOE may actually contribute to some types of adverse events and other medical errors. For example, the period immediately following CPOE implementation resulted in significant increases in reported adverse drug events in at least one study, and evidence of other errors have been reported. Collectively, these reported adverse events describe phenomena related to the disruption of the complex adaptive system resulting from poorly implemented or inadequately planned technological innovation.

Technological iatrogenesisedit

Technology may introduce new sources of error. Technologically induced errors are significant and increasingly more evident in care delivery systems. Terms to describe this new area of error production include the label technological iatrogenesis for the process and e-iatrogenic for the individual error. The sources for these errors include:

  • prescriber and staff inexperience may lead to a false sense of security; that when technology suggests a course of action, errors are avoided.
  • shortcut or default selections can override non-standard medication regimens for elderly or underweight patients, resulting in toxic doses.
  • CPOE and automated drug dispensing were identified as a cause of error by 84% of over 500 health care facilities participating in a surveillance system by the United States Pharmacopoeia.
  • irrelevant or frequent warnings can interrupt work flow

Healthcare information technology can also result in iatrogenesis if design and engineering are substandard, as illustrated in a 14-part detailed analysis done at the University of Sydney.

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