The mantra of modeling and the forgotten powers of paper: a sociotechnical view on the development of process-oriented ICT in health care

被引:68
作者
Berg, M
Toussaint, P
机构
[1] Erasmus Univ, Med Ctr, Inst Hlth Policy & Management, NL-3000 DR Rotterdam, Netherlands
[2] Leiden Univ, Med Ctr, Dept Clin Informat Sci, Leiden, Netherlands
关键词
medical records systems; computerized information systems; order-communication systems; software design; modeling; computer system development; organizational innovation; sociotechnical system development;
D O I
10.1016/S1386-5056(02)00178-8
中图分类号
TP [自动化技术、计算机技术];
学科分类号
0812 ;
摘要
The recognition that restructuring care processes is central to effective and efficient health care will result in the emergence of process-oriented electronic patient records (EPRs). How will these technologies come into being? Within informatics, it is often stated that to informate something, we should first model it. This paper queries whether a detailed modeling of work processes and data flows is the primary step that needs to be completed before such EPRs can be developed or tailored. Building upon a sociotechnical understanding of ICT development, we argue for a reinterpretation of 'models' in such development processes. We do so through a reverse engineering of parts of the paper-based medical record, which has received little attention in medical informatics. In process-oriented EPR design, we argue, modeling should not be conceived as the crucial first step in this design, but rather as an intervention in the organizational change-processes that constitute proper ICT development. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:223 / 234
页数:12
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