Human-centered design of a distributed knowledge management system

Rinkus, Susan; Walji, Muhammad F.; Johnson-Throop, Kathy A.; Malin, Jane T.; Turley, James P.; Smith, Jack W.; Zhang, Jiajie

doi:10.1016/j.jbi.2004.11.014

Cited by 84 publications

(53 citation statements)

References 16 publications

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“…1,[14][15][16][17] Regardless of the study focus, one theme consistently emerges: embedding CPOE in healthcare fundamentally changes the way clinicians coordinate their work activities and collaborate to deliver care. [18][19][20][21] Indeed, in our prior work we identified nine broad categories of unintended adverse consequences related to CPOE, negative impact on workflow emerged as the most frequently occurring theme. 18,22 The purpose of this current study was to explore these workflow issues in greater detail.…”

Section: Introductionmentioning

confidence: 96%

Computerized Provider Order Entry Adoption: Implications for Clinical Workflow

et al. 2008

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OBJECTIVE: To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems. METHODS:We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow.RESULTS: CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure. CONCLUSIONS:As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved. INTRODUCTIONHealth care providers use computerized provider order entry (CPOE) systems to place orders for medications, laboratory tests and other ancillary services. 1 CPOE has been shown to decrease medication ordering errors and redundant test ordering, promote practice standardization, and reduce overall healthcare costs. 2-4 Despite these benefits, CPOE systems have yet to be widely adopted for several reasons, including the high cost of implementation, clinician resistance to technology, worry regarding practice disruption and loss of productivity, fear of technology failure, and the inability of some CPOE implementations to integrate with existing healthcare systems. [5][6][7] Furthermore, there is evidence that unintended adverse consequences can surround the implementation and ongoing maintenance of these systems. [8][9][10] Recent, conflicting reports about the role of CPOE in the reduction of medication errors and associated costs have cast some doubt on the actual scale of improvements to be gained as CPOE systems have generated new kinds of medical errors, negatively affected patient outcomes, and resulted in higher overall medical costs for those institutions implementing them. 9,11-13 Thus, there remains a need for ongoing analysis of CPOE to understand the causes of these issues and help find solutions.A growing body of research explores the impact of integrating clinical information systems, including CPOE, within healthcare. 1,[14][15][16][17] Regardless of the study focus, one theme consistently emerges: embedding CPOE in healthcare fundamentally changes the way clinicians coordinate their work activities and collaborate to deliver care. [18][19][20][21] Indeed, in our prior work we identified nine broad categories of unintended adverse consequences related to CPOE, negative impact on workflow emerged as the most frequently occurring theme. 18,22 The purpo...

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Section: Introductionmentioning

confidence: 96%

Computerized Provider Order Entry Adoption: Implications for Clinical Workflow

et al. 2008

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“…This theory purports that both individual and collective cognition can be, and generally are, distributed across time and space (Cole & Engeström, 1993;Hutchins, 1995), for example, in a flight cockpit (Hutchins, 1995), a courtroom, or a medical practice (Engeström, 1992). More recently, the distributed cognition approach has been used as the basis for new methods of human-centered design that takes into account public sharing of memory and informal organization memory (Rinkus et al, 2005). Thus the distributed cognition ideas about public sharing of memory point out that, to understand how this phenomenon happens, one needs to sample data through many means, both by talking to members of the organization and by collecting data from a variety of sources about the use of computer systems.…”

Section: Work Analysis and Design Artifacts: A Case Of Distributed Comentioning

confidence: 99%

Designing a Simple Folder Structure for a Complex Domain

Clemmensen¹

2011

Human Technology

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“…First, MCC systems are not equipped with advanced technology to manage the terabytes of raw data generated daily. Previous attempts to do so have resulted in cumbersome, disjointed databases that lack structure and search capabilities, making information retrieval frustrating and sometimes unsuccessful [19].…”

Section: The Need For Improved Mission Control Situation Awarenessmentioning

confidence: 99%

Past, present and future implications of human supervisory control in space missions

2008

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Achieving the United States' Vision for future Space Exploration will necessitate far greater collaboration between humans and automated technology than previous space initiatives. However, the development of methodologies to optimize this collaboration currently lags behind development of the technologies themselves, thus potentially decreasing mission safety, efficiency and probability of success. This paper discusses the human supervisory control (HSC) implications for use in space, and outlines several areas of current automated space technology in which the function allocation between humans and machines/automation is sub-optimal or under dispute, including automated spacecraft landings, Mission Control, and wearable extra-vehicular activity computers. Based on these case studies, we show that a more robust HSC research program will be crucial to achieving the Vision for Space Exploration, especially given the limited resources under which it must be accomplished.

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Human-centered design of a distributed knowledge management system

Cited by 84 publications

References 16 publications

Computerized Provider Order Entry Adoption: Implications for Clinical Workflow

Computerized Provider Order Entry Adoption: Implications for Clinical Workflow

Designing a Simple Folder Structure for a Complex Domain

Past, present and future implications of human supervisory control in space missions

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