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Why is medical software so hard?

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Informatik - Forschung und Entwicklung

Abstract

Medical software is regarded as both a success and a risk factor for quality and efficiency of medical care. First, reasons are given in what respects the medical industry is special: it is highly complex and variable, exposed to risks of privacy/confidentiality but also of denied access to authorized personnel, and medical users are a highly qualified and demanding population. Then some software technology and engineering approaches are presented that partially master these challenges. They include various divide and conquer strategies, process and change management approaches and quality assurance approaches. Benchmark institutions and comprehensive solutions are also presented. Finally, some challenges are presented that call for approaches other than technical to achieve user “buy in”, handle the outer limits of complexity, variability and change. Here, methods from psychology, economics and game theory complement domain knowledge and exploratory experimentation with new technologies.

Zusammenfassung

Medizinische Software wird sowohl als Erfolgs- als auch als Risikofaktor für die Qualität und Effizienz medizinischer Versorgung gesehen. In diesem Artikel werden zunächst Gründe aufgeführt, inwiefern der medizinische Sektor sich von anderen abhebt: Er ist hoch komplex und variantenreich und den Risiken stark ausgesetzt, die sich aus Vertraulichkeit und Schutzbedürftigkeit der Daten einerseits und andereseits aus deren Nicht-Verfügbarkeit für autorisiertes Personal ergeben. Auch sind medizinische Nutzer hoch und vielfältig qualifiziert und entsprechend anspruchsvoll. Es werden dann Verfahren aus Software-Technologie und -Engineering vorgestellt, welche diese Herausforderungen z.T. meistern. Darunter befinden sich „Teile-und-Herrsche“-artige Partitionierungsverfahren, Prozess- und Änderungsmanagement- sowie Qualitätssicherungsmethoden. Einige richtungweisend erfolgreiche Institutionen und Lösungen werden erläutert. Schließlich wird auf Herausforderungen hingewiesen, bei denen andere als technische Zugänge naheliegen, damit anspruchsvolle Nutzer „einsteigen“ und grenzwertig schwierige Anforderungen an Komplexität, Variabilität und Änderungsintensität handhabbar werden. Dabei ergänzen Methoden aus Psychologie, Wirtschaftswissenschaften und Spieltheorie ein vertieftes Wissen über den medizinischen Gegenstandsbereich und das Experimentieren mit neuen Technologien.

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Authors and Affiliations

  1. Institute of Medical Biometry and Medical Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany

    Thomas Wetter

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  1. Thomas Wetter
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Correspondence to Thomas Wetter.

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CR subject classification

D.2.1; D.2.2; D.2.7; D.2.8; D.2.9; D.2.11; D.2.12; D.4.6; H.1.2; H.2.7; H.4.1; H.5.3; J.3; K.1; K.4.1; K.4.3; K.5.2

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Wetter, T. Why is medical software so hard? . Informatik Forsch. Entw. 22, 185–199 (2008). https://doi.org/10.1007/s00450-008-0043-7

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