Berg M, Langenberg C, vd Berg I, Kwakkernaat J
Health Ethics and Philosophy, Maastricht University, The Netherlands.
Int J Med Inform. 1998 Oct-Dec;52(1-3):243-51. doi: 10.1016/s1386-5056(98)00143-9.
This paper argues that we should understand the process of IT design as the development of sociotechnical configurations. Drawing upon our experiences with an electronic patient record (EPR) on an Intensive Care Unit (ICU), we depict medical work practices as natural systems. Several considerations for design are developed. First, the EPR should not be overly structured with rationalistic and prefixed notions of the organization and content of medical work. Implementing structure is crucial, however, this should be derived from detailed, empirical knowledge of the practice involved. Second, it is crucial to ensure that the usage of the system will yield immediate benefits for primary users: the systems should support work, not generate it. Third, designing IT should include being aware of the socio political nature of seemingly 'neutral' tools as EPRs.
本文认为，我们应将信息技术设计过程理解为社会技术配置的发展。基于我们在重症监护病房（ICU）使用电子病历（EPR）的经验，我们将医疗工作实践描述为自然系统。并提出了几个设计方面的考量。首先，电子病历不应被过于理性化和预先设定的医疗工作组织与内容概念所过度结构化。然而，实施结构至关重要，这应源于对相关实践的详细实证知识。其次，确保系统的使用能为主要用户带来直接益处至关重要：系统应支持工作，而非产生工作。第三，设计信息技术应包括意识到诸如电子病历这类看似“中立”工具的社会政治性质。
