Keltie's Digest Vol. 43 March 28th 2022

News

• This article is sad, but interesting - and not the first time. This nurse worked through multiple technology barriers before accidentally administering the wrong drug to the patient. At what point is the design of the process at blame? I am all for expecting critical thinking, but I do not think this is a single person failure. As informaticists we must think about what alerts/alarms/stops, when, what are the various scenarios, and tested scenarios in the workflow. Did the person who designed the ADU workflow test it within the CIS workflow? Did they test it only with drugs that are there vs. scenarios of failure? https://www.npr.org/sections/health-shots/2022/03/22/1087903348/as-a-nurse-faces-prison-for-a-deadly-error-her-colleagues-worry-could-i-be-next

Articles

• Building a??Learning?Health System??for?Canadians??Report?of the Artificial Intelligence for Health Task Force? https://cifar.ca/wp-content/uploads/2020/11/AI4Health-report-ENG-10-F.pdf
• This article is a bit intense. But think about this: A physicist is attempting to determine if information is the fifth state of matter. I.e. Information itself has a physicality beyond even the "physical dimension" that we often talk about. Depending on the result, this would put to bed the fundamental nature of information and hopefully help more to recognise information as a key aspect of our place within the universe (and therefore an enduring medium for Clausewitzean struggle). - Experimental protocol for testing the mass–energy–information equivalence principle https://aip.scitation.org/doi/10.1063/5.0087175
• Digitizing Health Records - a Clinical affair or a bystander https://medical-device-manufacturing-europe.medicaltechoutlook.com/cxoinsight/digitising-health-records-a-clinical-affair-or-bystander-nwid-2104.html

Implementing a CIS is not an "IT Project" has been a mantra in this industry for almost 20 years. But why is this something that in 2022 there are still projects being run as "IT projects" and then surprised they do not reach the benefits they expected? I plan to dig into the literature on this over the next few weeks and will let you know what I figure out! Some related articles here:

2020: Albert Auditor General reviewed the AHS CIS project. Among the key drivers of success for the AHS Connect Care program we observed to date are:

• The program was not led or managed as an “IT project.” Representatives of operations, clinical staff and physicians and AHS IT co-led the program. The involvement of operational and clinical staff in the program was pervasive.
• AHS assigned three of its senior executives as program “sponsors.” These were not passive roles. The extent of their involvement, the depth of their understanding, and the presence of these sponsors at critical times leading up to launch was noteworthy.
• We saw consistent evidence of a culture in the Connect Care program of transparency, accountability, and dedication. Teams gave straight answers, did not sugar-coat bad news, and asked for help. Leaders did not relent on important questions and were active in finding the resources teams needed if they were falling behind. https://www.oag.ab.ca/reports/ahs-wave-one-connect-care-feb-2020/

2017: EY review of Island Health CIS Implementation https://www.health.gov.bc.ca/library/publications/year/2017/review-of-Island-Health-IHealth-electronic-health-record-system.pdf

2012: "Perhaps the biggest source of trouble is the failure of executives to identify the right governance structure at the outset of the project. Too often, they automatically see any project involving technology as an IT project. But an EMR implementation is less about technology than it is about transforming your workflows and processes to be more efficient, more patient-centered, and more information-driven." https://ehrintelligence.com/news/why-emr-implementation-as-just-an-it-project-seldom-succeeds

• Field Guide to Data Science https://www.boozallen.com/s/insight/publication/field-guide-to-data-science.html

Webinars/Conferences/Podcasts

• What does the digital revolution hold for the clinical workforce https://www.youtube.com/watch?v=u72w_7gtZQM

Interesting Stuff