Titin.net

First I need to explain what is meant by the sharp end of health care. Health care systems can be looked at as a wedge with a sharp edge and a blunt edge. The blunt edge is where management lies. Clinicians directly caring for patients are at the sharp edge. Cognitive work at the sharp edge is more complex and less supported by IT. Unfortunately, there is simplification of these complexities. Changing and conflicting guidelines and varied patients response to treatments are two examples of ignored realities.

Clinicians are the most adaptive elements at the sharp edge end yet their needs must be supported. Developing user centred systems in this environment is oversimplified. Actually, this is an impossible job. The variability between clinicians prohibits reductionist approaches. Yet sciences as psychology, human factors and human-computer interaction should help. Naturalistic decision making approach can be used.

At the sharp edged, the coordination between human and machine needs better understanding. This is inlight that IT can help as can hinder cognitive work.

The authors call to improve the clinicians ability to perform despite changes and challenges; in other wards, to improve resilience.

ScienceDirect – Journal of Biomedical Informatics : Getting to the point: developing IT for the sharp end of healthcare