Four Rules for the Reinvention of Health Care
Last night, I read the article “Four Rules for the Reinvention of Health Care” (120 KB, .pdf) by Enrico Coiera. In essence, its’ focus is encapsulated by the following statement: “If health care is to evolve at a pace that will meet the needs of society it will need to embrace the science of sociotechnical design” (p. 1199). With this in mind, he identifies four rules to help guide future health care design:
- Rule 1: Technical systems have social consequences
- Rule 2: Social systems have technical consequences
- Rule 3: We don’t design technology, we design sociotechnical systems
- Rule 4: To design sociotechnical systems, we must understand how people and technologies interact
The author raises other important points, including:
- “If health care is to flourish in the coming setting of diminished resources and increased demand, then it will do so because we have explicitly designed and implemented new systems of care that are fundamentally sustainable.” (p. 1197)
- “In 2020 clinicians will care more effectively for more patients than today, because some burden of care has shifted away from individual clinicians. Some of that burden will rest with the consumer, who participates actively in maintaining good health and managing ill health. Some burden of care must also shift to machines, because without computational automation much of what needs to be done to make the system run will otherwise remain undone. Most importantly, our services and systems will need to be “designed” to meet our needs, in contrast to the inherited and patched up system we have at the present.” P. 1197)
- “Designing the technological tools that humans will use independently of the way in which the tools will affect the organization optimises only solutions that are specific to local tasks and ignores global realities.” (p. 1197)
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