title: The dangerous decade.
abstract: Over the next 10 years, more information and communication technology (ICT) will be deployed in the health system than in its entire previous history. Systems will be larger in scope, more complex, and move from regional to national and supranational scale. Yet we are at roughly the same place the aviation industry was in the 1950s with respect to system safety. Even if ICT harm rates do not increase, increased ICT use will increase the absolute number of ICT related harms. Factors that could diminish ICT harm include adoption of common standards, technology maturity, better system development, testing, implementation and end user training. Factors that will increase harm rates include complexity and heterogeneity of systems and their interfaces, rapid implementation and poor training of users. Mitigating these harms will not be easy, as organizational inertia is likely to generate a hysteresis-like lag, where the paths to increase and decrease harm are not identical.
authors: Centre for Health Informatics, University of New South Wales, Sydney, New South Wales, Australia. e.coiera@unsw.edu.au
authors: Enrico
authors: E
authors: Coiera
authors: Jos
authors: J
authors: Aarts
authors: Casimir
authors: C
authors: Kulikowski
mesh_terms: D003695:Delivery of Health Care / Q000592:standards / Q000639:trends; D005544:Forecasting; D006801:Humans; D007256:Information Systems / Q000592:standards* / Q000639:trends*; D019300:Medical Errors / Q000639:trends*; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D061214:Patient Safety; D011785:Quality Assurance, Health Care; D012984:Software / Q000592:standards; D014481:United States