Health IT and the Socio-technical Environment

HIT systems in live service rarely cause harm in isolation instead they form just one component (a cheese slice or hole) in a complex ecosystem in which human operators co-exist and interoperate with technology. This situation is often referred to as a socio-technical enviromnent. An understanding of this environment is important as scenarios which lead to harm also evolve from these relationships. Incidents are nearly always multifaceted and involve the interplay of historical design decisions, operating procedures, system architecture, training strategies and so on. 

Safety emerges from a careful evaluation of all the ecosystem s components and complex interactions. Only when these are understood can we begin to tackle the 

An adapted set of components from of Sittig and Singh s ecosystem is set out below  

To demonstrate how the different components of the socio-technical model can interact a fictitious but not atypical user story is set out below  

The patient suffered a gastrointestintil haemorrhage as a result of the duplicate therapy. 

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