Department of Development and Planning, Virtual Centre of Health Informatics, Aalborg University, Fibigerstræde 13, 9220, Aalborg Ø, Denmark.
BMC Med Inform Decis Mak. 2012 Aug 22;12:91. doi: 10.1186/1472-6947-12-91.
Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings.
A multiple case study including nine case studies conducted by DaCHI researchers 2004-2011 using audio-visual, non-participant video observation for data collection within different healthcare settings.
In HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices.
The video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.
经验表明，开发成功的健康信息技术的前提条件是对临床工作实践有透彻的了解。在当代临床工作实践中，临床工作和健康信息技术是相互结合的，其中一部分实践是隐性的。当工作实践变得常规化时，它就会退居到意识的背景中，如果没有上下文来支持回忆，就很难被识别。这意味着，使用传统的民族志研究方法或在可用性实验室或临床环境中很难捕捉到这些信息。在医疗保健环境中使用视频技术进行观察已被证明能够深入了解复杂的临床工作实践及其背景——包括隐性实践的部分内容。本文的目的是 1）论证视频观察技术在为健康信息技术的开发提供信息和改进方面的作用，以及 2）分享在医疗保健环境中使用视频观察技术时的益处和挑战方面的见解和经验教训。
一项多案例研究，包括 DaCHI 研究人员在 2004 年至 2011 年期间进行的 9 个案例研究，使用音频视觉、非参与式视频观察在不同的医疗保健环境中收集数据。
在 HIT 开发中，视频观察对于 1）为系统设计提供信息和改进、2）研究工作实践的变化、3）识别新的潜力和 4）记录当前工作实践非常有益。
在揭示临床工作实践的复杂性方面，在医疗保健环境中使用的视频观察技术优于其他民族志研究方法。与传统的民族志研究或可用性研究以及临床环境中的研究相比，获得的见解更加真实。此外，通过视频记录生成的数据为相关医疗保健专业人员之间的对话提供了坚实的基础。最重要的经验教训是，为了在数据丰富的分析阶段保持专注，必须考虑周到的方法和明确制定的目标。此外，视频观察技术主要推荐用于限定临床环境中特定临床工作实践的研究。总体而言，视频观察技术已被证明能够提高我们对临床工作实践与 HIT 之间交织关系的理解，并使我们了解用户对 HIT 的需求和需求，这是未来开发更成功的 HIT 系统的前提条件。
