A new sociotechnical model for studying health information technology in complex adaptive healthcare systems

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First Review

This is a review for the article by Dean Sittig and Hardeep Singh, A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. [1]

Background and Purpose

Stakeholders face a multitude of challenges during the design, development, implementation, use and evaluation of clinical information systems. There have been few models developed that address these challenges and none that do so comprehensively. This article introduces a new eight-dimensional model that takes into account the complex inter-dependencies among dimensions. The purpose of this model is to assist those working to implement and use health information systems in real-world settings to overcome barriers to success.

Results

Eight key success factors (dimensions) were identified. It is important that these dimensions be analyzed in relation to each other rather than sequentially or as independent parts. The sociotechnical dimensions are:

  • Hardware and software
  • Clinical content
  • Human-computer interface
  • People
  • Workflow and communication
  • Organizational policies and procedures
  • External rules, regulations and pressures
  • System measurement and monitoring

Conclusion

The eight-dimensional model introduced by these authors has been successfully used to study and implement health information technology interventions. Continued use and study of these eight dimensions and their inter-relationships will serve to improve the safety and effectiveness of Health information technology (HIT) applications.

Comments

This article succinctly captures the complex inter-dependencies between relevant aspects of any major information system project. Moreover, the authors show how this eight-dimension model has been used successfully in practice and offer lessons learned from previous implementations. The model is relevant for every stage of an implementation project. For example, when conducting a readiness assessment for an organization, it would behoove the project collaborators to address inter-dependencies of all dimensions in this model before further project planning begins.

Second Review

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References

  1. Sittig, D. F., & Singh, H. (2010). A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Quality and Safety in Health Care, 19(Suppl 3), i68-i74. doi:10.1136/qshc.2010.042085. http://qualitysafety.bmj.com/content/19/Suppl_3/i68.short