ABSTRACT
This chapter shows how difficult and challenging change in healthcare can be, and how difficult diagnosis is. Information technology (IT) not only provides important structure and support for diagnosis, but also adds complexity. Electronic orders for tests can include advice on the most appropriate choice, a functionality that is especially helpful in light of the growing menu of sophisticated tests. Recent gains have been made in the development and implementation of health information technology (HIT), and electronic medical records are now widely disseminated in most settings. HIT offers many features that ought to streamline processes, facilitate communication, and improve diagnostic accuracy. The current design of existing HIT fails to meet expectations. New problems are introduced by HIT that add risk. Success in achieving all the potential benefits of IT will require ongoing work to customize and design products that support diagnostic work.
