The Search for Synergy: Interrelating Medical Work and Patient Care Information Systems

Abstract

Summary Objectives: This article aims to search for the way patient care information systems can be most fruitfully put to work in health care. Methods: Given the calls for improved health care quality, there is a need for IT’s coordination capacities in health care. Yet IT’s track record in this area is less than many expected. Moreover, many argue that the nature of health care work sets natural limits to the possibilities of IT to revolutionize this work. Starting with an analysis of the paper record, this article explores the way IT and professional work can be interrelated synergistically. Results: Two principles are discussed: 1) The key to a fruitful operation of IT in health care work lies in the unraveling of the care process, and the redistribution of tasks between professionals and the IT application. 2) Professionals should be given the skills and resources to adapt the IT application’s demands to the needs of their work practices. Conclusion: IT can bring true process support to health care when taking the two principles discussed here into account.

Adherence factors to paperless primary healthcare: a focus group study

“…Modification of current primary care practice workflow and reduction of the usual physician and nurse workloads should also be a necessary part of these systemic changes. Successful development of eHealth in northern European countries suggests that ICT adoption on a national level depends largely on the maturity and sophistication of eHealth strategies and legislations (51,78). Physician and nurse scepticism about user-driven eHealth applications is confirmed by the second lowest rating received by the category "User-centred design of existing ICT".…”

“…Patient-centred applications are defined as systems that enable a partnership between practitioners, patients and their families (when appropriate), which ensures that procedures and decisions respect patient needs and preferences. It seems that redistributing ICT tasks between professionals, as well as adapting ICT tools to the needs of users, is crucial for ICT to effectively be used in clinical work (2,58,(75)(76)(77)(78)(79)(80)(81)(82). Therefore, it makes sense to increase the involvement of end-users in the implementation process (2,17,41,62,(79)(80)(81)(82).…”

Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation: Table 1

“…39 This does not occur automatically and users, engaged in their own work, have little time to present their information needs to the informatics department and follow-up on the design and implementation of changes. In this case, the IST worked with system developers and with the vendor to make changes to the system to support the nurses' goals, including the development of a CPOE-based workaround to enable nurses to communicate with colleagues on future shifts.…”

Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site

“…For the geriatric population, this service coordination among multiple providers necessitates a level of planning and communication beyond that seen in other care settings. An electronic health record (EHR) can foster communication among clinicians and across time [1][2][3] and place by facilitating coordination of data [4,5] with remote and asynchronous access to the patient record by multiple clinicians.…”