Box 5.1

A Segmentation of Health-Care-Related Technology Efforts


General applicability

Health care specific

Relatively clear path forward from existing technologies

Quadrant 1:

Quadrant 2:

General—applied efforts

Health care—applied efforts

Advanced research needed

Quadrant 3:

Quadrant 4:

General—advanced efforts

Health care—advanced efforts

needed to achieve success, the appropriate funding mechanisms, and other such parameters. For example, efforts in quadrants 1 and 3 might be pursued by computer science researchers working in loose cooperation with the health and biomedical informatics communities, whereas efforts in quadrants 2 and 4 would require much tighter coordination and cooperation.

These two dimensions emerge from the observation that health care IT draws on classic computer science challenges such as providing high availability with low system management overhead [C4O18], high data integrity, and a very high degree of usability. Such goals are essential foundations of many IT systems but are especially challenging to achieve in the context of health care IT, given the scale and diversity of the health care establishment and, in some cases, the need to support a large, broad user base. In addition, many benefits of systems often accrue only when they are viewed by researchers and caregivers as sufficiently trustworthy to replace older solutions. At the same time, some problems related to health care IT involve solutions that are highly specific to health care (e.g., developing high-quality devices for human-computer interaction [C1O2] that do not inadvertently help to spread infection as care providers move from patient to patient).

As an illustration of how a solution to a major problem in health care might be decomposed into a technology-related research agenda, consider that most clinicians spend a significant amount of time in documenting the care provided to a patient.2 One challenge for health care IT would be


The committee noted this point in its site visits. And the literature has important examples as well. For instance, a survey of more than 2500 clinical oncologists showed that the amount

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