Is your Health IT solution an ugly baby?
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25 May 2017, by , in Blog, No comments

For anyone who’s been a parent, the sight of your newborn child is undoubtedly the most beautiful and fascinating thing you will ever set eyes on. But, let’s face it, the harsh reality is that not all of those wrinkly bundles are blessed with equally endearing features. Sometimes we see what we want to see…it’s a good thing, it’s part of being human.

But this effect can become a hindrance when it comes to our ability to provide objective criticism of our less human creations. The more we invest in creating something the more biased we tend to become in evaluating its qualities. It’s a phenomenon which psychologists call Choice Supportive Bias or Post-Purchase Rationalization.

When it comes to creating software and, in particular, digital health products, those biases can seriously compromise our ability to see the flaws in the technology we create. When that technology is safety-critical, this can have very real and serious consequences.

In my role as a consultant in digital health safety, I occasionally find myself reviewing the spoils of sub-optimal software design; safety-critical user interfaces with complex nested scrolling windows and patient records which are unnecessarily fragmented or awkward to navigate. Sure, when those designs were drawn up the strategy made sense. But when flaws were eventually found, all too often the original decisions were defended and justified rather than being re-evaluated and re-worked.

Reviewing the design of a digital health product and its relationship with human factors is fundamental to the safety assessment which manufacturers are obliged to carry out under NHS Digital’s SCCI 0129 Standard. Yet, as an independent safety consultant, communicating these difficult messages to a product’s parental creators can require the most delicate of consultancy skills.

Darwin tells us that it’s not the fittest of the species that survives but the ones most adaptive to change. This is as true of software as it is biology. Sometimes we have to fix things to move forwards and acknowledge that this design evolution is not an admission of failure or guilt but rather a very real refinement of quality. If we turn a blind eye to the flaws in our safety critical health technology, however heavily we have invested in it, we are simply fooling ourselves. And if our pride prevents us from objectively evaluating the technology in the first place then our stoicism quickly borders on negligence.

And, for the record, my daughters are the most beautiful on Earth.

Dr Adrian Stavert-Dobson is the Managing Partner of Safehand, independent consultants in clinical risk management, and the author of Health Information System: Managing Clinical Risk.

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