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ISQua Education Global Debate

ISQua Education's Global Debate for 2015 was entitled:

"Health Information Technology is already improving healthcare safety and current regulation around it is sufficient".  

We would like to thank everyone for their participation on this debate.  We would like to extend a special word of thanks to all of our Speakers:

- Dr David W. Bates; 
- Professor Aziz Sheikh; 
- Professor Ross Koppel;
- Professor Dean Sittig; and
- Professor Guy Maddern

for all the time and dedication they gave to create this fantastic debate.    

The Result

Voting was open for three weeks, closing on 12th August 2015.  The votes were counted and the result was as follows:

Below are Peter Carter's observations on the outcome.  Even though voting is closed, you can still participate in this debate by listening to the speakers and posting your own comments in the comment box below.



The Votes are in as are the Comments: My Observations
Peter Carter, Chief Executive Officer

Peter CarterSo, the votes are in and the  WINNER is.................... !

The BLUE TEAM. By 56% to the ORANGE TEAM’S 44%.
So this proves conclusively that Health Information Technology is already improving healthcare safety and current regulation around it is sufficient – doesn’t it!?  Maybe….maybe not.

Firstly 56/44 is not exactly a resounding victory and secondly the comments received on the proposition, and there were many were mostly equivocal, on both sides.

The first observation made by many is that there are really two questions here which may or may not be related. It is possible to agree that HIT is improving safety but it is not sufficiently regulated AND, equally, that HIT is not making healthcare safer but it is sufficiently regulated. One could even make the argument that regulation is an impediment to HIT’s attempts to improve safety.

A second observation is that the various roles of vendors, clinicians, patients, managers, IT specialists and others in the development and implementation of IT solutions need to be mixed and matched much better than they are at present to achieve optimal improvement.

So, yes, HIT is in some, perhaps many, even most –places and cases improving healthcare safety but it will better realise its potential if we are cleverer in how we design and employ it AND no, regulation around it is probably not sufficient or, perhaps, not always appropriate.

This DEBATE, as with the one before it on the ageing population, and as, we hope, will be future debates, is about learning from each other and exchanging information and testing our ideas on experts and peers.

Blue Team: For the Proposition

Orange Team: Against the Proposition


Aziz Sheikh

Professor Aziz Sheikh, Centre of Medical Informatics, The University of Edinburgh


Dean Sittig

Professor at UTHealth School of Biomedical Informatics (SBMI). 



Ross Koppel

Adjunct Professor of Sociology; Principal Investigator, Center for Clinical Epidemiology and Biostatistics, School of Medicine; Senior Fellow at the Wharton School’s Leonard Davis Institute for Healthcare Economics.

Guy Maddern

RP Jepson Professor of Surgery, University of Adelaide; Director of Surgery, The Queen Elizabeth Hospital and Royal Adelaide Hospital;  Director of Research, Basil Hetzel Institute for Translational Health Research at The Queen Elizabeth Hospital.  


Substantial evidence exists to show that HIT can improve safety, and it is being increasingly widely adopted in many developed countries. While there are some isolated reports that make it clear that implementation of EHRs in particular does sometimes create new safety issues, these are mostly case reports and anecdotes. If HIT were more tightly regulated, this could severely inhibit innovation in HIT development and tighter regulation would thus not result in safety improvement and might well even make safety worse.  

HIT has considerable potential to benefit patient care, population health and the efficiency of care delivery, and although this is now being achieved in some contexts there are still major issues with poor functionality and usability which potentially compromises the safety of care; that said, there is no evidence to indicate that large number of patients are being harmed on a regular basis by HIT.


Healthcare Information Technology (HIT) continues to hold immense promise for reducing medical errors, collecting instant and vast data from across medical providers, increasing efficiency, improving clinician and patient satisfaction, guiding clinicians, and facilitating teamwork. Yet, everywhere clinicians find this technology frustrating and falling short of its promised benefits. 


The fact that HIT is already improving patient safety should be abundantly clear to anyone who can even remotely remember what healthcare was like in the pre-computer age. With the recent advances in technology, our newly acquired capability to measure and monitor various aspects of medical care has already had a significant positive impact on the safety of healthcare and this will only increase as we learn more about how to collect and interpret these large databases. 


Innovation continues to be introduced in an unregulated fashion throughout the healthcare system.   Doctors, hospitals and institutions have conflicts of interest that are poorly disclosed and even more poorly managed.   Regulation remains variable around the world and permits innovations and changes in one jurisdiction and forbids it in another.   Both cannot be correct.   


Note for Fellowship Participants 

To gain credit points for your Fellowship, complete this activity in FELIX, ISQua's learning management system, under the Health Improvement Technology track to earn one credit point.