Macadamian Blog

The Gears of Healthcare

The healthcare industry works a lot like the agile software development cycle. Each morning doctors and residents meet to discuss what happened yesterday and agree on a strategy for each case for the day. The next day the cycle repeats with possibly different staff and different patients. As a result, healthcare is very process driven. It needs the structure to be able to maintain synchronization between all the people all playing their different and independent roles.

Software written for the healthcare domain has to respect these processes. If it doesn’t, it will be difficult to use and get rejected. One mistake often made, however, is the assumption that the processes are linear in nature, much like the waterfall software development cycle. For example, the patient visits admissions, then goes off to receive treatment and then gets discharged, without ever having to move back to an earlier stage.

Often it is the case where the patient is admitted emergently in an unconscious state or with an inability to speak and retrieving the data from him for admissions is impossible. Each subsequent stage in the course of the patient’s treatment depends on this step and yet it is not reasonable that it should block any other stage. Each system which could be affected must provide the ability to enter patient demographic information in a temporary or delayed fashion. With this ability also comes the need for the application to support the management and correction of these temporary records. Typically these records would be fixed the next day or whenever the information can be obtained with certainty. The user needs to be reminded about which records are outstanding, otherwise they will be forgotten indefinitely.

When it comes to a clinical application, the key element to remember is that at the end of the process what counts is that the relevant data get recorded, not that it get recorded in the right order. Like a machine, rust only builds up if the parts stop moving. Healthcare is no different. The gears have to keep moving because the patients can’t wait.