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Faithful to the Earth: Reporting Experiences of Artifact-Centered Design in Healthcare

  • Federico CabitzaEmail author
Conference paper

Abstract

In this paper we report about two design experiences in the domain of healthcare information technology that shed light on the advantages of getting rid of complex and abstract representations of hospital work and of concentrating on the artifacts that practitioners habitually use in their daily practice. We ground our approach in the recent literature on the often unintended shortcomings exhibited by healthcare information systems and propose a lightweight method to support the phases of requirement elicitation and functional design. We then discuss the main requirements expressed in our recent research activity and provide examples of how to address them in terms of modular and artifact-centered design solutions.

Keywords

Health Practitioner Electronic Patient Record Application Logic Business Rule Hospital Work 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Bower, A.G.: The diffusion and value of healthcare information technology. The CERNER Quarterly Q3 (2005) 16–26Google Scholar
  2. 2.
    Goorman, E., Berg, M.: Modelling nursing activities: electronic patient records and their discontents. Nursing Inquiry 7(1) (2001) 3–9CrossRefGoogle Scholar
  3. 3.
    Hartswood, M., Procter, R., et al.: Making a case in medical work: Implications for the electronic medical record. CSCW 12 (2003) 241–266Google Scholar
  4. 4.
    Koppel, R., Metlay, J.P., et al.: Role of computerized physician order entry systems in facilitating medication errors. JAMA 293 (2005) 1197–1203CrossRefGoogle Scholar
  5. 5.
    Sidorov, J.: It ain’t necessarily so: The electronic health record and the unlikely prospect of reducing health care costs. Health Affairs 25(4) (2006) 1079–1085MathSciNetCrossRefGoogle Scholar
  6. 6.
    Poissant, L., Pereira, J., et al.: The impact of electronic health records on time efficiency of physicians and nurses: A systematic review. JAMIA 12(5) (2005) 505–516Google Scholar
  7. 7.
    Chaudhry, B., Wang, J., Wu, S., et al.: Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine 144 (2006) 12–22Google Scholar
  8. 8.
    Ash, J.S., Sittig, D.F., et al.: The extent and importance of unintended consequences related to computerized provider order entry. JAMIA 14(4) (2007) 415–423Google Scholar
  9. 9.
    Harrison, M.I., Koppel, R., Bar-Lev, S.: Unintended consequences of information technologies in health care – an interactive sociotechnical analysis. JAMIA 14 (2007) 542–549Google Scholar
  10. 10.
    Illich, I.: Medical nemesis, the expropriation of health. Marion Boyars Publishers Ltd, London (2000/1975)Google Scholar
  11. 11.
    Palmieri, P.A., Peterson, L.T.: Technological iatrogenesis: An expansion of the medical nemesis framework to improve modern healthcare organization performance. Proceedings of the Western Academy of Management 2008, Oakland, California, USA (2008)Google Scholar
  12. 12.
    Wears, R.L., Berg, M.: Computer technology and clinical work still waiting for godot. JAMA 293(10) (2005) 1261–1263CrossRefGoogle Scholar
  13. 13.
    Grudin, J.: Why CSCW applications fail: Problems in the design and evalutation of organizational interfaces. In CSCW ’88, Portland, Oregon, USA, ACM Press (1988) 85–93CrossRefGoogle Scholar
  14. 14.
    Norman, D.A.: The design of everyday things. Doubleday, New York (1990)Google Scholar
  15. 15.
    Berg, M.: Medical work and the computer-based patient record: A sociological perspective. Meth Inform Med 37 (1998) 294–301Google Scholar
  16. 16.
    Wieringa, R.J.: Requirements engineering: frameworks for understanding. Addison-Wesley, Reading, MA (1996)Google Scholar
  17. 17.
    Schmidt, D.: Model-driven engineering. IEEE Computer 39(2) (February 2006) 25–31CrossRefGoogle Scholar
  18. 18.
    Spolsky, J.: Joel on software: And on diverse and occasionally related matters that will prove of interest to software developers, designers, and managers. Apress (2004)Google Scholar
  19. 19.
    Robinson, M., Bannon, L.: Questioning representations. In ECSCW’91, Amsterdam, The Netherlands (1991)Google Scholar
  20. 20.
    Kensing, F., Sigurdardottir, H., Stoop, A.: MUST – a participatory method for designing sustainable health IT. Studies in Health Technology & Informatics 129(2) (2007) 1204–1208Google Scholar
  21. 21.
    Scandurra, I., Haegglund, M., Koch, S.: From user needs to system specifications: Multi-disciplinary thematic seminars as a collaborative design method for development of health information systems. Journal of Biomedical Informatics 41(4) (2008)Google Scholar
  22. 22.
    Nièsa, J., Pelayo, S.: From users involvement to users’ needs understanding: A case study. In press International Journal of Medical Informatics (2009)Google Scholar
  23. 23.
    Berg, M., Toussaint, P.: The mantra of modeling and the forgotten powers of paper: A sociotechnical view on the development of process-oriented ICT in health care. International Journal of Medical Informatics (2002) 69(2–3):223–234Google Scholar
  24. 24.
    Schmidt, K., Wagner, I.: Ordering systems: Coordinative practices and artifacts in architectural design and planning. CSCW 13(5–6) (2004) 349–408Google Scholar
  25. 25.
    Strauss, A.: Work and the division of labor. TSQ 26(1) (1985) 1–19CrossRefGoogle Scholar
  26. 26.
    Berg, M.: Of forms, containers, and the electronic medical record: Some tools for a sociology of the formal. Science, Technology and Human Values 22(4) (1997) 403–433CrossRefGoogle Scholar
  27. 27.
    Hartswood, M., Procter, R. et al.: Co-realisation: towards a principled synthesis of ethnomethodology and participatory design. Scandinavian Journal of Information Systems 14(2) (2002), 9–30Google Scholar
  28. 28.
    Silverston, L.: The Data Model Resource Book. Wiley, New York (2007)Google Scholar
  29. 29.
    Chen, P.: The entity-relationship model: Toward a unified view of data. ACM Transactions on Database Systems 1(1) (1976) 9–36CrossRefGoogle Scholar
  30. 30.
    Wirth, N.: Program development by stepwise refinement. Communications of the ACM 14(4) (1971) 221–227zbMATHCrossRefGoogle Scholar
  31. 31.
    Batini, C., Ceri, S., Navathe, S.B.: Conceptual database design: an entity-relationship approach. Benjamin-Cummings Publishing Co., Inc., Redwood City, CA, USA (1992)zbMATHGoogle Scholar
  32. 32.
    Bardram, J.E., Bossen, C.: A web of coordinative artifacts: collaborative work at a hospital ward. In GROUP’05, New York, USA, ACM Press (2005) 168–176Google Scholar
  33. 33.
    Winthereik, B.R., Vikkelso, S.: Ict and integrated care: Some dilemmas of standardising inter-organisational communication. CSCW 14(1) (2005) 43–67Google Scholar
  34. 34.
    Ellingsen, G., Monteiro, E.: Seamless integration: Standardisation across multiple local settings. CSCW 15(5–6) (2006) 443–466Google Scholar
  35. 35.
    Suchman, L.A.: Plans and situated actions: The problem of human-machine communication. Cambridge University Press, Cambridge (1987)Google Scholar
  36. 36.
    Cabitza, F., Sarini, M., et al.: “When Once Is Not Enough”: The role of redundancy in a hospital ward setting. In GROUP’05, Sanibel Island, Florida, USA, ACM Press (2005) 158–167Google Scholar
  37. 37.
    Cabitza, F., Simone, C., Sarini, M.: Leveraging coordinative conventions to promote collaboration awareness. CSCW 18 (2009) 301–330Google Scholar
  38. 38.
    Cabitza, F., Simone, C., Zorzato, G.: ProDoc: an electronic patient record to foster process-oriented practices. In ECSW’09, Vienna, Austria, Springer, September 9–11 (2009)Google Scholar
  39. 39.
    PricewaterhouseCoopers: Patients or paperwork? The regulatory burden facing america’s hospitals. Technical report, American Hospital Association (2001)Google Scholar
  40. 40.
    Strauss, A., Fagerhaugh, S., Suczek, B., Wiener, C.: The social organization of medical work. University of Chicago Press, Chicago, IL (1985)Google Scholar
  41. 41.
    Dyro, J.F.: Clinical engineering handbook. Academic Press series in biomedical engineering Biomedical Engineering Series. Academic (2004)Google Scholar
  42. 42.
    Illich, I.: Tools for conviviality. Harper & Row, New York, NY, USA (1973)Google Scholar
  43. 43.
    Henry Lieberman, F.P., Wulf, V. (Eds.) End-user development. Springer, Berlin (2006)Google Scholar
  44. 44.
    Garfinkel, H.: ‘‘Good” organizational reasons for “bad” clinic records. In Studies in Ethnomethodology, Prentice-Hall, NJ, USA (1967) 186–2006Google Scholar
  45. 45.
    Gadd, C.S., Penrod, L.E.: Dichotomy between physicians’ and patients’ attitudes regarding emr use during outpatient encounters. AMIA Symposium (2000) 275–279Google Scholar
  46. 46.
    Ash, J.S., Berg, M., Coiera, E.: Some unintended consequences of information technology in health care: The nature of patient care information system-related errors. JAMIA 11 (2004) 104–112Google Scholar
  47. 47.
    Bringay, S., Barry, C., Charlet, J.: Annotations: A functionality to support cooperation, coordination and awareness in the electronic medical record. In COOP’06, France, Provence (2006)Google Scholar
  48. 48.
    Campbell, E.M., Sittig, D.F., et al.: Types of unintended consequences related to computerized provider order entry. JAMIA 13(5) (2006) 547–556Google Scholar
  49. 49.
    Cabitza, F., Simone, C.: LWOAD: A specification language to enable the end-user development of coordinative functionalities. LNCS 5435, Springer (2009) 146–165Google Scholar
  50. 50.
    Cabitza, F., Simone, C.: WOAD: A framework to enable the end-user development of coordination oriented functionalities. Journal of Organizational and End User Computing 22(1) (2009)Google Scholar
  51. 51.
    Atkinson, C.J., Peel, V.J.: Transforming a hospital through growing, not building, an electronic patient record system. Methods of Information in Medicine 37(3) (1998) 285–293Google Scholar
  52. 52.
    Wenger, E.: Communities of practice. Learning, Meaning and Identity. Cambridge University Press, Cambridge (1998)Google Scholar
  53. 53.
    Aarts, J., et al.: Understanding implementation: The case of a computerized physician order entry system in a large Dutch University medical center. JAMIA 11(3) (2004) 207–216Google Scholar

Copyright information

© Springer London 2010

Authors and Affiliations

  1. 1.Università degli Studi di Milano BicoccaMilanoItaly

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