A voice against irrational exuberance in ehealth

For those interested in a somewhat contrarian viewpoint about ehealth, I suggest you check out Scot Silverstein.  I just recently came across his site documenting some "common examples of health care IT difficulties".  You can also listen to his interview available via the Government Health IT site – an excellent site.

In his interview, Dr. Silverstein raises some very important points:

• Technology companies don’t fully understand the complex, fast-paced, amorphous nature of health care.  Health care is not like other industries.
• The concept of using technology in health care is valid, but it must be done right.  Today, implementation and the realities of the technologies just aren’t good enough (yet).
• We need to go far beyond "user centered" design.  Clinical involvement is mandatory because many systems are designed using incorrect assumptions.
• Governments should focus on developing and enforcing standards.

My interest in Dr. Silverstein’s work is in our common view on technology:  that there’s great potential to make positive changes, but that success isn’t a certainty – what is commonly referred to as "technological determinism".  I’ve written as far back as 2004 about technological determinism and ehealth, namely to be skeptical about the absolute certainty that the IT professionals have about ehealth (e.g., my post about IBM building computer models to solve health care’s woes).  I think it’s important to have a balanced view on being hopeful of the possibilities, but also being realistic about the challenges (some final thoughts from a 2005 ehealth conference).

I hope to do some more reading on his website to see what other nuggets I can glean from his work.

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