Health Informatics Discussion Forum

This is the discussion thread for Component 2, Unit 10, Lecture C of the MOOC:


Consider the statement "changes in technology require clinicians to make substantial changes to the way they deliver patient care". Do you agree or disagree? Defend your position.

You need to be a member of Health Informatics Forum to add comments!

Join Health Informatics Forum

Email me when people reply –


  • I disagree, Irrespective of the changes in Technology, Clinicians should make the minimum change in their approach to deliver Healthcare. If the Clinician is expected to move to a different way of working because the technology is better, it will again require a learning curve to be good at it.

    As the standard phrase goes... IT  should fit into Healthcare and not the other way round.

    • I think that sometimes the technology is an enabler of change rather than just an automation of a physical process or a way to improve efficiency. For example, the introduction of ultrasound technology offered physicians a way to significantly change the way they approach diagnosis and treatment of certain diseases.

      However, for a lot of technology, I agree with you - the ideal is that the technology follows the clinical practice and not the other way round. We've just been having a discussion on twitter about this topic:

      • What if the clinical practice differ from physician to physician, and no clinical guideline followed in the clinical practice and no standard (as ICD10 ) is used. in this case technology will not only require to automate and enhance performance of clinical practice, it will be also required to fill the gap between physician actually does and the standards and guidelines.

        We cannot automate something that is non-standardized non-unified, we have to fix it first. 

        • This is a significant issue in many implementations. Often, there is no established evidence base to even create a guideline so a compromise has to be reached. If a large new system is being installed, it is sometimes more cost-effective to use standardised workflow templates that may or may not adhere to evidence based guidelines or be appropriate for the locality. It often comes down to a case of cost versus perfection.

          The ideal world is that clinicians first establish up-to-date evidence based practices that are as efficient as possible using paper (or existing) systems and then migrate to the same practice using EHRs. The reality when time and budget constraints come into play may be different!

          • Yes.. Until and unless we implement Evidence Based Medicine and adopt a standardized form of delivering care..any Healthcare IT application trying to adopt templates, work flows, care plans etc..will be difficult to achieve success..

            • I think we have to do both at the same time. Iteration is the key - as we develop better evidence we should be able to upgrade the IT systems to include this. There are so many gaps in the evidence that we would be waiting forever to implement IT if we don't make a few compromises.

  • "changes in [Information] technology require clinicians to make substantial changes to the way they deliver patient care". This, regrettably, is what is happening today when it should not be so

    Any changes in patient-care should happen only through peer review in the hands of clinicians and as per needs of patient care and safety - again as seen fit by clinicians.  IT is but a tool - and a tool is there help the physician, Making a physician make substantial change to his processes to suit the tool is nothing but a failure on the part of the tool maker. I have, many a time, seen a programmer throw in a ready made component into an app that 'roughly works' rather than precisely write code to adhere  to the required specs, exactly. Why? - because it is less effort, they say. It is never to be forgotten that a programmer works very hard so that the user does not have to!  It is this sloth, inadequate domain knowledge and perhaps commercial pressures that lead to "clinicians requiring to make substantial changes to the way they deliver patient care" to use the said tool. Truly a case of the tail wagging the dog.

    So let me say it again - The most excellent technology is that which is extremely easy (for the physician ) to use safely and with the minimum disruption to his work flow or time.

    Dr Lavanian Dorairaj

    • Thanks for your thoughts Dr Dorairaj. There is always a balance between perfection and cost (or even laziness!) but we should certainly be striving for minimal disruption to workflow.

      Do you think that educating programmers about 'evidence based medicine' would help them prioritise clinically designed pathways over solutions that are easier to program or implement?

    • I believe developing and IT tool for the user there should be collaboration with both parties from the onsets to determine requirements and what is expected and usability studies to determine it functionality but that is in the ideal world. The reality is that IT personnel are faced with a lot of constraints deadline, time, budget, lack of clear definition of what is expected, lack of corporation from clinicians, common excuses no time between seeing patients and discussing with programmers on the needs so the clinicians should not complain when the get programs that do not integrate with their workflow, it very crucial for the programmer to understand the manual workflow to be able to to translate this to computational codes, bearing in mind that there are some aspects that may not have direct translational. The programmer cannot achieve this without the willing corporation of the clinician.

      Also lack of standards or clinical guidelines can be very frustrating for the programmers who spend hours to codify this elements until there is uniformity standards EHR integration and adoption would continue to be at slow pace and few facilities would be eligible for the meaningful act initiatives / incentives     

  • Ofcourse clinicians need to change the way they deliver patient care because technolgy will now enforce guidelines, give patients access to clinicians outside office hours, and across regional boundaries and demand more responsibilty
This reply was deleted.


Search the Forum