Health Informatics: A Socio-Technical Perspective
Kelman, Chris, Health Sociology Review
HEALTH INFORMATICS: A SOCIO-TECHNICAL PERSPECTIVE Sue Whetton Melbourne: Oxford University Press 2005; PB 262 pp, AUD 59.95 ISBN 019 555078 1
Sue Whetton's text is a comprehensive review of the state-of-the-art of Health Informatics. The book is fairly lengthy, partly because she defines the discipline in a much broader manner than I am accustomed to. In her definition, Whetton has included everything related to data or information management that has anything to do with health care. Initially, I resisted this rather catholic approach. However, as I read on, I realised the relevance of her subtitle: A Socio-Technical Perspective. The whole point of the work is to emphasise the relevance of a socio-cultural perspective and to explore the dynamics between health informatics and the socio-cultural environment of health. Health informatics is very much Information Technology in the service of health care. It is not an end in itself; to be useful, it must engage with the users, so it is appropriate that Whetton includes all aspects of information management from accounting and staff management, clinical records, decision support systems, telemedicine and research, to surveys and consumer opinion polls.
Whatever the scope of the definition, Health Informatics is here to stay. Modern Information and Communications Technology (ICT) has a habit of generating massive amounts of data. In health care, these data describe both what we know about medicine and what we do with this knowledge. In both these areas, the quantity of data is already so vast that we cannot cope with it without the aid of (increasingly powerful) computers. The potential benefits for the management of these electronic resources are exciting, and achieving such dividends as a national electronic patient record, systematic safety monitoring of medicines and seamless communication across systems is the goal of the 'health informaticiari. However, none of the various e-Health initiatives underway in Australia or overseas provide a model of success: it is clear that health informatics is a vital discipline that is rapidly evolving in the primeval soup of increasingly complex medical care and increasingly capable ICT.
The author starts by reminding us of the widespread optimism common in the last century that ICT would 'break down barriers, bring economic growth and prosperity and generally enrich the lives of individuals and communities around the world'. While ICT has certainly brought great benefits in many areas, most would agree that in health care, the promises have far outstripped the results. The book provides a basis for explaining this rather disappointing situation and gives some insight into the causes of the many conflicts that have slowed the introduction of informatics in health.
The discussion covers the early tensions between technocentric enthusiasm and the limitations and complexities of health care politics, resource constraints, organisational inertia and the poor management that often sabotaged worthy developments in new areas. …