We had dinner the other night with a doctor and his wife who live in our neighbourhood. I knew he worked in the emergency room, but over the course of a delicious meal he explained he lived a double life at work, in an area of research I’ve never heard of before.
He said he specialized in “implementation science” – in other words, the study of how best practices get adopted by medical practitioners. Or in some cases, why they don’t get adopted. The latter, of course, is the area of greater concern. We all know the medical community is constantly churning out new research, engaging in clinical trials and occasionally even coming up with new techniques for treatment and even cures. Why on Earth wouldn’t a doctor worth his or her salt want to take advantage of such process?
There are a couple of reasons, the doctor told me. Sometimes there’s no awareness of the breakthrough treatment or best practice. Sometimes there’s a lack of available training or equipment. And sometimes, of course, there are psychological or cultural factors among health-care practitioners who have honed their skills over years of experience, and who may be as resistant to change as their patients. Throw in costs and a few other factors and you can understand why the advancement of implementation science may boost the fortunes of many other fields.
We seldom describe the implementation of IT as a science, though the same kinds of inhibitors and barriers are there. Vendors and consultants usually try to address the awareness and training issues, and great leaders push through the psychological roadblocks, but it often seems to happen on a case-by-case basis. What if there was real effort into creating a branch of implementation science around enterprise technology – treating “science” as it was originally intended as a method of discovery rather than a fixed dogma? Imagine if we were able to derive best practices for working with best practices, and how it could be integrated in the curriculum of computer science and business schools.
Implementation science is sometimes referred to as the “translation” of evidence into practice. This rings true for the IT industry, where some theoretical models make attractive (or merely dense) eye charts but don’t hold up to the reality of heterogeneous data centre environments. Even the word “evidence” reminds me of the emphasis IT managers have been putting on return on investment (ROI) for what they spend towards technology. In health-care, evidence-based medicine is about making life better. Whether we ever develop implementation science for IT or not, I think the ROI for technology should be pretty much the same.
