These are just some of the innovations that could shape our health services in 2020, according to an article in this week's BMJ.

Over the next 20 years, national health systems will have to treat proportionately more people, with more illness, using relatively fewer tax dollars and workers, yet these systems are already under significant strain.

To flourish in this setting, we must design new systems of care that are fundamentally sustainable, and this may require nothing less than the reinvention of health care, argues Professor Enrico Coiera from the University of New South Wales.

This journey to reinvent healthcare begins by recognising that health systems are "sociotechnical" systems, where people and technologies interact, he writes.

He proposes four rules, based on this thinking, which could help guide the active design of our health services.

If health care is to evolve at a pace that will meet the needs of society it will need to embrace this science of sociotechnical design, but ultimately it is our culture's beliefs and values that shape what we will create and what we dream, he concludes.

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Contact: Emma Dickinson
edickinson@bmj.com
44207-383-6529
BMJ-British Medical Journal
13-May-2004