My experience is limited, but everything I know suggests that much IT in healthcare diminishes medical care. It may serve certain administrative functions (who is attending what clinic and when etc), and, of course, there are certain particular use cases — such as repeat prescription control in primary care — but as a tool to support the active process of managing patients and improving medical decision making, healthcare has no Photoshop.
In the US it is said that an ER physician will click their mouse over 4000 times per shift, with frustration with IT being a major cause of physician burnout. Published data show that the ratio of patient-facing time to admin time has halved since the introduction of electronic medical records (i.e things are getting less efficient). We suffer slower and worse care: research shows that once you put a computer in the room eye contact between patient and physician drops by 20-30%. This is to ignore the crazy extremes: like the hospital that created PDFs of the old legacy paper notes, but then — wait for it — ordered them online not as a time-sequential series but randomly, expecting the doc to search each one. A new meaning for the term RAM.
There are many proximate reasons for this mess. There is little competition in the industry and a high degree of lock-in because of a failure to use open standards. Then there is the old AT&T problem of not allowing users to adapt and extend the software (AT&T famously refused to allow users to add answering machines to their handsets). But the ultimate causes are that reducing admin and support staff salaries is viewed as more important than allowing patients meaningful time with their doctor; and that those purchasing IT have no sympathy or insight into how doctors work.
The context is wildly different — it is an exchange on the OLPC project and how to use computers in schools, but here are two quotes from Alan Kay that made me smile.
As far as UI is concerned — I think this is what personal/interactive computing is about, and so I always start with how the synergies between the human and the system would go best. And this includes inventing/designing a programming language or any other kind of facility. i.e. the first word in “Personal Computing” is “Person”. Then I work my way back through everything that is needed, until I get to the power supply. Trying to tack on a UI to “something functional” pretty much doesn’t work well — it shares this with another prime mistake so many computer people make: trying to tack on security after the fact …[emphasis added]
I will say that I lost every large issue on which I had a firm opinion.