Promises broken....

Today I wanted to talk about a problem I see in IT that’s what I believe to be IT’s biggest “Asleep at the switch” syndrome. As with a lot of things in this world, it is both a matter of perception from without as well as a “Well what else can we do” attitude from within. The point for me was driven home by a sickeningly disheartening affair that occurred with one of our clients. As you might know TAI has authored, maintains, augments, and advances several varieties of electronic health records. While most of us would like to believe the altruistic nature of the users are well received by those individuals that are being served, the facts are that in some cases these people are troubled to the point of being a danger to others as well as themselves.

In this particular case a user was murdered by the very person being helped by them. Engaging with people in the community as a matter of one’s job is certainly nothing new for practically everybody in the work force today but when those engagements might prove dangerous, it’s imperative that the computer systems built as tooling for those vocations provide ample support for warning of the potential dangers involved. As a response to this incident we implemented additional messaging and tracking of information within our system used by this client, allowing for dissemination of information which was always there. The new feature packages this information in a new way, bringing it to the forefront of the presentation. Forcing users of the system to see said information if it exists.  

In the aftermath of the incident, our client has of course undergone a number of procedural alterations to deal with the potential of this kind of thing occurring in the future. The system additions featured above being just one such example. The real measures that will provide the real protections against this kind of thing are not metered out in cyberspace but are invoked here in meat space. The particular thing that provoked my return to this dusty blog however is the comments our client have received, specifically regarding the measures implemented in the computer system.

Our client has expressed to us that their clients were amazed at the speed at which a systems change was made to the EHR. I find that “amazement” to be a problem. It’s not that the feature was implemented in the system; it’s that the feature was implement is such a short time that is drawing the praise and kudos. That is what I am struck with. With all the efforts our client has put into making changes with how they deal with this harmful potential, this little piece of system kit that assists in the JOB our client has should be minor by comparison. Being amazed that the changes in presentation were implemented so quickly are what I find interesting, and alarming all at once.

I personally have read a great deal of written materials detailing the glacial pace of change in some aspects of IT system development. Having been personally involved in a few efforts that have ground to a halt in the dogma that is process change control, I can say that the phrase “It would take an act of congress” might just as well be applied here.  This I find to be modern IT systems development greatest failure. While I do see the need for measured and calculated deliberation in the implementation and augmentation of modern computer information system small and large. The various levels of sign off that are required in most of these engagements are far too ponderous. The time required to even make minor changes in wording onscreen in most of these efforts is ridiculous. The unfortunate thing about all this is that the user community has simply grown accustom to it. Having been powerless to affect this glacial pace they see the situation as being “just the way it is”. That is what I find to be shameful from an IT perspective, being surprised by the rapid implementation of a systems feature for useful application in a problem domain aught not be met with praise by the users of said system. Rapid application development is the promise of modern system development paradigms. A promise that all too often has been broken by the not so modern layers of people and process involved in modern system development.