Sammendrag
This research takes a novel approach to developing computerised record (EHR) system interfaces, by observing information-intensive cooperative processes in a hospital ward, and categorising and analysing information requirements, decisions and production. We have developed a framework that will be used to find requirements to the “Mobile Electronic Patient Chart unit” (MEPC); a context and procedure-aware, speech-based, multi-modal inter-face to the EHR, being developed as part of the MOBEL (MOBile ELectronic patient chart) project at the NTNU. We are challenged by the widespread use of paper-based charts in "paper-less" hospitals. To get a general view of information and communication practices in the wards, non-participatory, qualitative observational studies were performed at the Univ. Hospital in Trondheim. The purpose was to identify situations that would improve, change, or even become superfluous by introducing the MEPC. To analyse and structure the observations, we developed a framework of attributes describing roles, process, input, and output and corresponding values. The framework was used to identify important aspects of the ward situations that would benefit from the MEPC. Results from the observations and corresponding analysis demonstrate that decision-making and planning usually takes place shortly after information retreival, often in a clearly delimited group process. The existing EHR is not useful in tight cycles of retreival-decision-planning, as it is not always updated nor is easily available. The observations reveal a need for systems supporting cooperation and activity planning. This implies that the EHR, and MEPC, must integrate today’s archival functions with integrated, simple support for actions like ordering/booking/referrals, and new tools for organizing future actions. The planning and organization of actions must be managed/recorded in a common interface that is guideline-oriented and integrated with the EHR.
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