Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

Abstract

The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paperbased medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the HyPR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work.

Clinicians’ Attitudes and Practices on Technology-Supported Notetaking: A Survey

“…This resonates with the observations made by Houben et al (2015), although their participants were medical students. They remarked that the heavy reliance on paper to document medical records seems incongruent with the extent to which EHRs are integrated into healthcare systems in general.…”

“…The explanation can probably be boiled down to the fact that paper makes clinicians more efficient, given its inherent naturalness and other affordances. Houben et al (2015) also referred to Harper et al's (1997) framework of paper affordances -flexibility, markability, portability and accessibility, all of which can be adduced in explaining our results.…”

“…However, the results of usability studies on such devices remain inconclusive (e.g. Houben et al 2015). Indeed, how to enhance the usability and user experience of healthcare technologies is an ongoing challenge for a number of HumanComputer Interaction (HCI) researchers, who collaborate closely with clinicians.…”

Collaborative Affordances of Medical Records

“…In order to provide a technical design to mitigate the challenges of aligning and configuring paper-based and electronic records, the notion of an augmented hybrid patient record (HyPR) have been proposed (Houben et al 2014a;Houben et al 2015). Figures 8 and 9 shows the HyPR medical record.…”

Hybrid Patient Record – Supporting Hybrid Interaction in Clinical Wards

“…Paper documentation is used as transitional artefacts [3] to bridge the gap between the day to day work in the hospital and the workflows provided by the EHR in use. Some studies even show that the paper record is still even being used as full archival patient record [5]. At its core, the physical and collaborative affordances of the entire paper record are difficult to replace or support in the EHR.…”