Arizona State University, USA.
Health Informatics J. 2019 Sep;25(3):536-548. doi: 10.1177/1460458219833095. Epub 2019 Apr 19.
Research on interoperability and information exchange between information technology systems touts the use of secondary data for a variety of purposes, including research, management, quality improvement, and accountability. However, many studies have pointed out that this is difficult to achieve in practice. Hence, this article aims to examine the causes for this by reporting an ethnographic study of the data work performed by medical records coders and birth certificate clerks working in a hospital system to uncover the practices of creating administrative data (e.g. secondary data). The article illustrates that clerks and coders use situated qualitative judgments of the accuracy and authority of different primary medical accounts. Coders and clerks also employ their understandings of the importance of different future uses of data as they make crucial decisions about how much discretion to exercise in producing accurate data and how much effort to put toward clarifying problematic medical data. These findings suggest that information technology systems designed for interoperability and secondary data also need to be designed in ways that support the qualculative practices of data workers in order to succeed, including making future uses of data clear to data workers and finding ways to minimize conflicting data before data workers encounter it.
研究信息技术系统的互操作性和信息交换，提倡出于各种目的（包括研究、管理、质量改进和问责制）使用二次数据。然而，许多研究指出，在实践中这很难实现。因此，本文旨在通过报告一项对在医院系统中工作的病历编码员和出生证明文员所执行的数据工作的人种学研究，来探讨造成这种情况的原因，以揭示创建行政数据（例如二次数据）的实践。本文说明了文员和编码员使用对不同主要医疗记录的准确性和权威性的情境定性判断。编码员和文员还利用他们对数据未来用途重要性的理解，在做出关于在生成准确数据时行使多少自由裁量权以及在澄清有问题的医疗数据方面投入多少努力的关键决策时。这些发现表明，为了实现互操作性和二次数据而设计的信息技术系统还需要以支持数据工作者的定性实践的方式进行设计，包括向数据工作者清楚地说明数据的未来用途，并找到在数据工作者遇到之前最小化冲突数据的方法。
