“Safeware”: Safety-Critical Computing and Health Care Information Technology

摘要: Information technology (IT) is highly promoted as a mechanism for advancing safety in health care. Ironically, little attention has been paid to the issues of care IT. Computer scientists have extensively studied problem assured performance safety-critical computing systems. They developed conceptual approach and set techniques use settings where incorrect or aberrant operation (or results from correct that are context) might endanger users, public, environment. However, these methods not commonly used IT, which generally without specific consideration special factors unique requirements safe operations. This article provides brief introduction professionals informaticians what called “safeware,” comprehensive hazard analysis, design, operation, maintenance both hardware software considers entire joint sociotechnical system (including its operators) over lifecycle, conception through on decommissioning. Adoption safeware should enhance trustworthiness future Introduction Twenty-five years ago, Lissane Bainbridge coined phrase “ironies automation” refer observation introducing automation into complex improve often simultaneously introduced new problems degraded performance. 2 Despite this experience, belief advanced information critical by strongly held academics, public officials, vendor, business, civic groups. 4, 5, 6, 7, 8, 9 The anticipated benefits IT presented discussions sort manifest destiny—difficult, be sure, but ultimately inevitable. While there many about challenges, costs, priorities, other planning implementing virtually no discussion how make itself patients, practitioners, organizations. irony seeking systems may begin with seems lost enthusiasm remaking via Past experience shown it an unequivocal success. 14 Hardware failures propagated unexpected ways remote, ostensibly unrelated components common network ; upgrades lead missing false laboratory information; programming mistakes similarly led guidance decision support;