Answers in a great post from Healthcare Renewal who have by far the most comprehensive views on technology implementations in health systems that I have come across.
“I do not think “political appeal” is a good justification for a multi-billion dollar cybernetic experiment in medicine, where the risks of the technology are considerable and where basic healthcare needs are not being well met among the poor and underprivileged.
Former ONC Chair David Brailer is quoted:
“People confuse information automation with creating the kind of work environment where productivity and creativity can flourish,” said Dr. David J. Brailer, who was the national health technology coordinator in the George W. Bush administration. “And so little has gone into changing work so far.”
Brailer was little better than Jha, and moves the goalposts with a type of circular logic. He appears to be saying that technology that will revolutionize medicine can’t work until we change how things are done in medicine so the technology can revolutionize medicine.1“
This may be why there is an increase in technology companies partnering with big pharma so that regulation can be skipped which means the several hundred year old issues of marketing a product with claims that cannot be clinically or scientifically proven will continue and there will not be an economic dividend other than short term benefits for the boards and senior members of those companies.
This is not just systems, devices, apps – there are some obvious incredible benefits with development of radiotherapy, key hole surgery, robotic surgery in some cases etc
It’s the claims of the rest without scrutiny about their safety and efficacy. Advanced algorithms (now commonly called & hyped AI) and doctors/nurses vocation are not interchangeable. Do no harm is commonly used in scifi and technology literature but do no harm is at the core of the humans that are in clinical professions especially those in public services. They are not concepts that politicians and technology companies can understand in the same way unless they have previously worked in those professions or partly in similar public services protecting public safety.
On a related note, The Politics of NHS Market Reforms
1. Silverstein S (2016)NY Times/Steve Lohr asks “Why the Economic Payoff From Technology Is So Elusive.” The answer in medicine is obvious, http://hcrenewal.blogspot.co.uk/2016/06/ny-timessteve-lohr-asks-why-economic.html