Monday, November 30, 2009

Cerner attempted "suppression" of a critical report

A story entitled "Claim of censorship over Cerner system" in Computer Weekly has alerted me (and probably many others) to a report, by Professor Jon Patrick from Australia - The Story of the Deployment of an ED Clinical Information System6.0.pdf which is critical of Cerner FirstNet.

The paper presents an international and historical overview of comments about Cerner software implementations in a variety of hospital and healthcare systems, before focussing on the specific implementation in New South Wales. A variety of issues are highlighted, perhaps best summarised by the statement "The problem of designing a satisfactory Clinical Information System is that it is non-deterministic, that is, it is not possible to know all requirements in advance, because of the variety of the users it has to satisfy is effectively a Complex System."

Issues around contracts, relationship between the healthcare organisations and company responsiveness are accompanied by the finding that "the user interface software .... is organised in a rigidly hierarchical manner that does not fit the Australian hospital workflow and which makes it highly inefficient for data retrieval."

The essay has some interesting things to say, based on the comments of clinicians and managers using the system, although I'm sure its rigour will be criticised, however I suspect it would have languished largely unread if a representative of Cerner had not contacted the university department publishing it, leading to it being removed and then reinstated, which has brought it to a much wider audience.

Perhaps this in itself is indicative of a cultural clash between a large commercial sector organisation and public sector and academic traditions.

I am also party to a contract with Cerner, which, at present, impinges on what I can say about the particular project I manage. I intend at a later date to be publishing an evaluation to help others.

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