A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems

This is a review for Sittig and Singh's 2010 article "A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems."

Introduction and Background

Prior to the development of this model, none existed that took into account all aspects of the complex adaptive healthcare systems that health information technology (HIT) is being implemented in. These complicated systems demanded a better conceptual model for studying the complex relationships between all of the moving parts involved in a health care system equipped with HIT.

Existing models (Henriksen's model, Vincent's framework for analyzing risk and safety, Carayon's SEIPS model, and Harrison's ISTA framework) helped inform the development of this model, but none broke down all aspects of technology individually or included a dimension regarding monitoring or governance structures, which the authors determined were essential when considering this new technology-filled health care system.

Moving Towards a New Socio-technical Model for HIT

This new model was proposed to study the "design, development, use, implementation, and evaluation of HIT"

The 8 Dimensional Socio-technical Model Includes:

• Hardware and Software Computing Infrastructure: equipment and software used to power, support, and operate clinical applications and devices

• Clinical Content: textual or numeric data and images that constitute the "language" of clinical applications

• Human Computer Interface: all aspects of the computer that users can see, touch, or hear as they interact with it

• People: everyone who interacts in some way with the system, from the developers to end-users, including potential patient-users

• Workflow and Communication: processes or steps involved in assuring that patient care tasks are carried out effectively

• Internal Organizational Policies, Procedures, and Culture: an organization's internal structures, policies, and procedures affect every other dimension in the model.

• External Rules, Regulations, and Pressures: accounts for the external forces that facilitate or place constraints on the design, development, implementation, use, and evaluation of HIT in the clinical setting.

• System Measurement and Monitoring: the effects of HIT must be measured and monitored on a regular basis.