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The Health IT Rollout: Supporting the End Users

Information and communication technologies (ICTs) are being rolled out rapidly in all aspects of health care (Tyrell 2002; van Bemmel & Musen 1997). Patient registration systems, business systems, and electronic patient record systems are coming to hospitals, to ambulatory care practices, and to most other health care organisations. For many, this modernisation cannot come too soon. After all, other service sectors such as travel, personal finance, and an increasing number of government departments use electronic systems as the backbone of their work, and could not envisage returning to manual methods. For many health staff this is, however, an unwelcome and somewhat frightening initiative. Working with electronic systems is not merely modernisation for professional staff; it represents a totally new work paradigm. This comprises two dimensions: understanding and using computer technology, and learning how to record their clinical work in a structured and apparently impersonal format. Both these developments are at first sight hostile and unwelcoming. A second difference is that whereas staff in sectors such as insurance or banking will be using the new technology as the basis of their jobs, and are therefore both willing and able to be trained thoroughly in this area, in health care such activity is often but a part (though an important one) of their daily professional duties. Thus health sector modernisation through computerisation can be seen as an agent of disempowerment and a threat for old and new staff alike.