Lin Ching-Ping, Gennari John H
Biomedical and Health Informatics, University of Washington, Seattle, WA, USA.
AMIA Annu Symp Proc. 2011;2011:455-64. Epub 2011 Oct 22.
Health information systems tend to be designed primarily for data retrieval and data entry, with insufficient attention paid to the larger contexts in which work occurs. As a result, low physician acceptance and satisfaction remain barriers to the successful integration of current informational and decision support systems (e.g., CPOE systems). This paper reports on a qualitative field study of team-based clinical care work and decision making. Our aim is to consider a radical redesign of clinical information systems, one that is built with context and the constraints of work practice in mind. We apply Cognitive Work Analysis (CWA) methods to characterize the work at a large children's hospital, and analyze these results to consider new designs for clinical information systems. In this study, we report on themes, constraints, and ideas for design, showing how our CWA analyses lead to designs that are very different from current technology information systems.
健康信息系统往往主要设计用于数据检索和数据录入，而对工作开展的更大背景关注不足。因此，医生的低接受度和满意度仍然是当前信息和决策支持系统（如计算机化医嘱录入系统）成功整合的障碍。本文报告了一项关于基于团队的临床护理工作和决策的定性实地研究。我们的目标是考虑对临床信息系统进行彻底重新设计，即在设计时考虑到工作实践的背景和限制因素。我们应用认知工作分析（CWA）方法来描述一家大型儿童医院的工作，并分析这些结果以考虑临床信息系统的新设计。在本研究中，我们报告了设计的主题、限制因素和想法，展示了我们的CWA分析如何得出与当前技术信息系统截然不同的设计。
