TY - CONF T1 - Doctors and Psychosocial Information: Records and Reuse in Inpatient Care T2 - Proceedings of the ACM Conference on Human Factors in Computing Systems (CHI’10) Y1 - 2010 A1 - Xiaomu Zhou A1 - Mark S. Ackerman A1 - Kai Zheng KW - EHR KW - electronic patient records KW - health informaticshealth informatics KW - information access KW - information reuse KW - medical information KW - medical records KW - organizational memory KW - physician information needs KW - psychosocial information AB -

We conducted a field-based study at a large teaching hospital to examine doctors’ use and documentation of patient care information, with a special focus on a patient’s psychosocial information. We were particularly interested in the gaps between the medical work and any representations of the patient. The paper describes how doctors record this information for immediate and long-term use. We found that doctors documented a considerable amount of psychosocial information in their electronic health records (EHR) system. Yet, we also observed that such information was recorded selectively, and a medicalized view-point is a key contributing factor. Our study shows how missing or problematic representations of a patient affect work activities and patient care. We accordingly suggest that EHR systems could be made more usable and useful in the long run, by supporting both representations of medical processes and of patients.

JF - Proceedings of the ACM Conference on Human Factors in Computing Systems (CHI’10) UR - Complete ER - TY - CONF T1 - I just don't know why it's gone: Maintaining Informal Information Use in Inpatient Care T2 - ACM Conference on Human Factors in Computing Systems (CHI'09) Y1 - 2009 A1 - Xiaomu Zhou A1 - Mark S. Ackerman A1 - Kai Zheng KW - CPOE KW - electronic patient records KW - informal information KW - medical informatics. KW - medical records KW - organizational memory KW - psychosocial information KW - shift change AB -

We conducted a field-based study examining informal nursing information. We examined the use of this information before and after the adoption of a CPOE (Computerized Provider Order Entry) system in an inpatient unit of a large teaching hospital. Before CPOE adoption,
nurses used paper working documents to detail psychosocial information about patients; after the CPOE adoption, they did not use paper or digital notes as was planned. The paper describes this process and analyses how several interlocked reasons contributed to the loss of this information in written form. We found that a change in physical location, sufficient convenience, visibility of the information, and permanency of information account for some, but not all, of the outcome. As well, we found that computerization of the nursing data led to a shift in the politics of the information itself – the nurses no longer had a cohesive agreement about the kinds of data to enter into the system. The findings address the requirements of healthcare computerization to support both formal and informal work practices, respecting the nature of nursing work and the politics of information inherent in complex medical work.

JF - ACM Conference on Human Factors in Computing Systems (CHI'09) UR - Complete ER -