I find Dr. Grove's approach interesting. He focuses on the "keep is simple" (KISS) principle and is rightly worried about huge spending on unproven information systems. He also proposes the widespread deployment of simple "walk-in" clinics to lower the cost and improve access to medical care. These ideas have a lot to recommend them. Large software projects almost always fail in one way or another... often spectacular failure. There is a limit to how much you can change in any system and these large projects change everything. Add to that the fact that they are often poorly designed and administered and they are destined to fail. On information systems... Adopting complex proprietary systems is also a recipe for failure. My brother in law is working for a group of hospitals on their IT conversion. He recently related that a project where three proprietary vendors were supposed to work together had failed to achieve any of its goals and they were in an advanced state of finger-pointing. They were supposed to set up proprietary communication among the three proprietary systems (each of them complex applications) and it wasn't working. No surprise here. If they had started with simpler open systems and open standard communication protocols, this would have given the project a chance of success and they could have called in new vendors when the original contractors failed to deliver. As it is now, they are stuck throwing good money after bad or just abandoning the project.
Simple open systems and open communications standards have the best chance of success. You also want a distributed system which can grow with small successes and not be hindered by the failure of central choke points to perform. This is much like the Internet itself where you have simple open communication protocols and distributed development. If ATT had been given a lot of money to develop the Internet, they would have designed a project like that in the UK (centralized control and proprietary standards) and it would have failed. The Internet has been spectacularly successful because it was designed with simple open communication protocols and it could be implemented in a distributed manner. People who could get it together to follow the simple protocols were successfully connected and they weren't impeded by those who couldn't follow simple directions. /Mark --- In openhealth@yahoogroups.com, Will Ross <[EMAIL PROTECTED]> wrote: > > With regard to the underestimated complexity of Healthcare IT, the > recent comments by Andrew Grove are relevant. > > "But a key problem with this plan is the lack of a good medical > records system, Grove said. His solution? Not the complicated, > expensive medical record-keeping system that many companies and > health-care providers are trying to develop, but something much > simpler—the use of existing mass-produced technologies." > > http://news-service.stanford.edu/news/2006/november8/med- > grove-110806.html > > - - - - - - - - > > [wr] > > - - - - - - - - > > On Nov 25, 2006, at 6:05 AM, ivhalpc wrote: > > > I presumed then and still presume that Mr. Gates like just about > > everyone else grossly estimates the difficulty of Healthcare IT. > > Optimism in this business is a disease that infects even those who > > should know better such as faculty at schools of health informatics. > > For example, classic software project management techniques are taught > > as gospel and adhered too rigorously despite a demonstrated high > > failure rate. I suppose you have to teach something. > > > > -- IV
