Radiology vs IT: Who needs to change?

Posted by Martin P in Lessons learned      No comments

Jan
1

As I was pinging a reply to Doc Dalai’s IT-bashing, it became less of a reply and more of an article in itself so I thought I’d put it here.

I’m primarily an IT guy, although with some qualifications in Medical Physics.  I’d like to think I’m more of a help than a hindrance but I’ve certainly seen some extreme examples of the latter that explain (at least partially) where some of the schism arises.

There are good reasons for entrusting IT services to a service department.  The fact is, IT professionals have the skills (usually), the time (sometimes) and the mandate (always) to know stuff that even enthusiastic non-professionals don’t.  As an extreme example – on a number of occasions – online and face-to-face – I have had to explain to folk in a technical decision making position why the question:

Which is beter for my PACS – RAID or SAN?

…is a dumb question, which really, really, really, should not be asked.

Abstracting a given set of service functions to a separate department is always going to create boundaries that must be overcome at a cost, and that certainly isn’t confined to IT. I recall in the mid-90′s when working for a large US multinational (in London), which due to the nature of its operations had an unusually active Health and Safety department.  As a result, the maintenance department had a rule that every plug/fuse combination must be tested once a year and if the test expired, that plug MUST NOT BE USED, even though they were not always able to perform that function in good time.  Now how disruptive is that?  The complexity and reliance that organisations in every industry place on IT means that any over-zealousnous has a disproportionate impact really only precedented by electricity services in the past.

I know of IT professionals in the healthcare industry who would like to take a strong stance on what can be restrictive policies such as security.  Like the plug testing rule, all of these policies are, in themselves, good ideas, but it can be easy for zealotry in creep in.  Even though there is much evidence (here and here – ok perhaps that last one isn’t exactly evidence ) that security advice doesn’t protect against the very real risks faced, the fact that the risks are real is undeniable, and precautions MUST be taken.

The bottom line is this: The management in any organisation must first realize for themselves, and secondly communicate to all organisational units (especially IT – but certainly not only – remember even Radiology is in itself largely a service department to other clinical specialties) that each service cannot be considered an island. Decisions in one department can have significant impact in other departments, which affect the delivery of the overall mission.  That message sometimes get lost in the noise generated by management targets and ‘Key Performance Indicators’.

But then again, there has to be a balance.  If everybody consulted everybody else about the impact of every decision, absolutely nothing would get done.  Some people find the balance, and some don’t.

So to answer the original question – who needs to change?  I think in many cases, probably no-one.  There are places (certainly on a department-to-department relationship level) that find that sweet spot. But in many others, it should be said:

• IT staff need to be part of the solution and not part of the problem – and know it!
• End users (certainly not just in Radiology) need to be aware that actually there are good reasons why security protocols are in place, or the servers need to go down for an hour every month.. because there are, but realistically, having to explain why will make everything take sooooooo much longer.

I don’t believe even the zealots are too far from that goal.  The biggest step is for folk to trust their colleagues to be part of the solution.  Trust is built rather than delivered. But its a two-way process.  Now there’s a thought for the New Year.