Dr Jim Bagian, credited with curing space motion sickness, was in Dunedin yesterday for a health sector workshop, part of a New Zealand tour organised by the Health Quality and Safety Commission.
Now director of the Centre for Healthcare Engineering and Patient Safety at the University of Michigan, Dr Bagian is a staunch advocate of communication.
It meant being blunt about the number of patients who died because of inadequate systems, he said.
Decisions on spending should be made calculating the ''hard numbers'' of preventable deaths, with clear rationale for all to see.
When decisions were taken behind closed doors, people suspected various agendas. Dr Bagian took part in two space missions, in 1989 and 1991, and was an investigator for the 1986 Challenger space shuttle crash.
A trained engineer and medical doctor, in 1997 he became the Veterans Health Administration's first chief patient safety officer.
In the United States, it had long been standard practice to place barcodes on patients, which were checked before they were given medication.
This cut medication errors from 16% to almost none. While technology in general made health safer and faster, it had potential risks.
''One has to be judicious as you start to employ it, to understand what the downsides are.
''When you automate things, if you have made errors in assuming what it's capable of, it can also very quickly do bad things too.''
Machines were only as good as the humans who made them.
''We don't know nearly enough in medicine to have a machine do everything.''
Factors such as doctor-patient interaction were important for picking up cues that machines missed.
Sometimes older technology was superior to new technology, because potential flaws were better known, he said.
