It is the aspect from which any analysis of the Privacy Guarantor starts and which we should ask ourselves every time we define an ICT project, because digitization is a tool but not the end.
Those who follow this blog know my thoughts on privacy and my doubts about some decisions of the Guarantor. The analyzes that this carries out always start from an in-depth study of the “purpose of data processing”, i.e. the reasons and rules that authorize a legal entity to collect and store sensitive data.
I must say that I often ask myself the same question when I review digital health projects not to evaluate their adherence to the GDPR but to understand their usefulness and therefore their cost effectiveness. The answers I find are very heterogeneous and range from “I collect data because it is useful to have them for the prevention, treatment and planning of health services” (any reference to national / central projects is purely coincidental …), “I digitize processes because I have to get rid of paper” but to “I replace an old system because it is obsolete or does not have all the functions that are needed”.
They are all statements that concern how do i reach the goal ma they don’t describe it. This or these are not explicitly stated nor elaborated upon. What does it mean to take better care of a person? How? What tangible benefits do I have in replacing paper with digital? In what aspect of the healthcare professional’s work will I gain an advantage? I know that to many these questions will seem trivial if not downright stupid. For many, the equation digital = advantage is a dogma that requires no further thought.
But what are the potential advantages or benefits that digitization can bring to healthcare?
The figure shows some aspects in which digitization can improve the governance of the healthcare system, clinical practice or patients’ lives. It can, but it’s by no means a given that it will. Try an exercise: examine a project or a tender specification and find those requirements or functions that lead to real improvement and are not described as ends in themselves. Then look for a value or an indicator that can measure them, that defines the objective in a quantitative key. You won’t find it. There are many generic, subjective, therefore discretionary assumptions.
The acceptance test serves to evaluate whether the system works, whether it complies with the specifications and can be put into operation. There is no subsequent moment aimed at evaluating the real usefulness of the system, the impact this has on the work and results of the users. In other words, no assessment of the value of the investment made. I put the electronic health record into operation and achieved my goal. Whether this helps healthcare professionals make fewer mistakes, treat more patients than before, or achieve better clinical outcomes is beyond any analysis.
Here then is that, unexpectedly, I share the Guarantor’s approach in starting any evaluation from the purposes of the treatment, albeit in my case to think about the usefulness of an investment in the digitization of a healthcare environment. Perhaps, who knows, a guarantor of the effectiveness of investments in health would be needed, obliging the regions and public health agencies to think critically about the use of the financial resources employed.
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