We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byKatelyn Orr
Modified over 3 years ago
©2003 Sowerby Centre for Health Informatics at Newcastle Problems Encountered in Electronic Health Record Research K. Neil Jenkings Sowerby Centre for Health Informatics at the University of Newcastle, University of Newcastle-upon-Tyne, Tel: (0191) 243 6181 Fax: (0191) 243 6101 firstname.lastname@example.org
©2003 Sowerby Centre for Health Informatics at Newcastle Aims Introduction The Problem of Fitness for Purpose The Problem of Modelling The Problem of Previous Research Strategies The Problem of Gatekeepers The Practical Problem of Data Representation Discussion.
©2003 Sowerby Centre for Health Informatics at Newcastle Introduction This paper attempts to highlight what some of the problems for researchers, other than purely technological capabilities, are that can be encountered in electronic health records research. EHR Scope
©2003 Sowerby Centre for Health Informatics at Newcastle EHR Scope large multi-disciplinary health and social care environment not under the management of a single authority differing bodies have both formal and informal structures and working patterns and communication structures legacy systems: not confined to communication hardware and software formal and informal work organization personnel organisational memory previous initiatives and experience of work collaboration and current pilot initiatives not sponsored by Electronic Health Record projects.
©2003 Sowerby Centre for Health Informatics at Newcastle The Problem of Fitness for Purpose Ready-to-Hand Unready-to-Hand At such times, inspection and practical problem- solving occur, aimed at repairing or eliminating the disturbance in order to get going again. In such times of disturbance, our use of equipment becomes explicitly manifest as a goal-orientated activity, and we may then try to formulate procedures or rules. (Suchman 1987 p53) Requirement for detailed descriptions of work But we arrive with legacy systems in place and, more significantly, legacy rationalisations of why those systems do not operate in the desired fashion. The problem being their ability to set the agenda for EHR requirements and design
©2003 Sowerby Centre for Health Informatics at Newcastle The Problem of Modelling Models that do not adequately reflect the everyday world Producing products where readiness-to-hand is absent. Risk of producing reality disjunctures on users The disjuncture between the ideal and reality may be so significant that it generates significant dissonance and conflict, leading to abuse, misuse and disuse of tools and systems May only produce adaptation and coping strategies In either case inadequate description can lead to unreadiness-to-hand products that are not fit-for- purpose
©2003 Sowerby Centre for Health Informatics at Newcastle The Problem of Previous Research Strategies Imperative that we have detailed information as to what occurs at these sites – and why Actual activities official and unofficial the why question not being predetermined by official or formal accounts whose versions are designed to fit in with service provision protocols A whole industry has grown up providing quantitative services to, and within, the NHS. Design and implementation activities have relied upon non-existent or inadequate gloss descriptions of the actual activities of healthcare professionals they wish to support or transform. The problem being a preference for quantitative strategies has now become a legacy of previous strategies.
©2003 Sowerby Centre for Health Informatics at Newcastle The problem of gatekeepers Users as Guardians of privacy Powerful professional bodies Hierarchical Organisation Gatekeepers determining access and hence methodology Respondents who speak on behalf of (but in effect, instead of) their employees, i.e. those who handle much of the inter-healthcare organisation and patient communication, and talk authoratively about work practices which they do not do and often have never done.
©2003 Sowerby Centre for Health Informatics at Newcastle The practical problem of data representation process model approach almost a universal standard for NHS managers at all levels Consequently a major resource for the designers of EHRs technologies. Need to accommodate this preference Models need not be information poor Problem of prose representation Lengthy and inaccessible The challenge is not only to collect detailed information, but also to be able to represent it to an audience with a preference for process model representations of the world
©2003 Sowerby Centre for Health Informatics at Newcastle Discussion Five interrelated problems The Problem of Fitness for Purpose The Problem of Modelling The Problem of Previous Research Strategies The Problem of Gatekeepers (methodology) The Practical Problem of Data Representation Ethnographic dimension of our work is not a substitute for the managerial or architectural perspectives but that these three perspectives have to be combined appropriately if the concept of EHR is to result in tools that are ready-to-hand and thus meet political and clinical needs
Ethnography and Evaluation Dr. K. Neil Jenkings DuDEHR.
Guidelines Recommandations. Role Ideal mediator for bridging between research findings and actual clinical practice Ideal tool for professionals, managers,
Working with Information Governance
Ethics and Governance of Clinical Information. Ethics, Confidentialty and Consent Ethical approach Trust Joint Act of Publication Forum for Governance.
©2001 Sowerby Centre for Health Informatics at Newcastle Progress on Virtual Medical Record HL7 Salt Lake City.
Integral Health Solutions We make healthcare systems work in harmony.
Educational Template Chapter 3 eHealth a Global Priority Pamela Hussey and Margaret Ann Kennedy Chapter 3 eHealth Global Priority.
The purpose of this Unit is to enable individuals to develop the key principles, values and attitude which are central to high quality care practice Key.
Informatics and the Goals of Obamacare Barry Smith 1.
Review of Infoway’s COPD* Use Case for Care Plan Business Requirements Sasha Bojicic, Canada Health Infoway Ron Parker, Canada Health Infoway
©2002 Sowerby Centre for Health Informatics at Newcastle The National Perspective ICRS The Durham & Darlington Approach Where to Start? Ian Purves ?
Improving outcomes for older people: Monitoring and regulating standards Ann Close 8 th June 2011.
California Department of Public Health / 1 CALIFORNIA DEPARTMENT OF PUBLIC HEALTH Standards and Guidelines for Healthcare Surge during Emergencies How.
NHS Education & Training Operating Model from April 2013 Liberating the NHS: Developing the Healthcare Workforce From Design to Delivery.
LOGO Mamdouh Abdel Aziz Refaiy Dr. Associate Professor, Business Administration Department, Faculty of Commerce, Ain Shams University, Cairo, Egypt. Evaluating.
Assessments 10 th November 2014 Community Offer - Workshop.
Patient access to on-line records Policy perspective Peter Short National Clinical Lead GP Department of Health Informatics Directorate & GP Partner in.
Centre for Health Services Research University of Newcastle upon Tyne.
MANAGING INFORMATION SYSTEM IN HIS IN DEVELOPING COUNTRIES.
A summary of the PSS-05 URD template
Methodological Framework for the Assessment of Governance Institutions P. Diaz and A. Rojas PFRA Workshop, March 17, 2006.
Example Incident Mgmt Initiation No recording of Incidents Users can approach different departments Solutions of previous incidents are not available.
Introduction To Pharmacy Management
Chapter 2 The Process of Strategic Management. Strategic Management 4e., Viljoen & Dann © 2002 Pearson Education Australia 2 Objectives understand and.
Engineering in the modern society Professional profile of a modern engineer Engineer as a key personality in the technological and social progress.
ERP Implementation Fundamentals Richard Byrom Oracle Consultant, Speaker and Author
Advanced Research Methodology
Health Management Information Systems Unit 3 Electronic Health Records Component 6/Unit31 Health IT Workforce Curriculum Version 1.0/Fall 2010.
Quick Guide to help your transition
Unit 4 FISCAL PLANNING " BUDGETS ". 2 A budget: “plan that uses numerical data, to predict the activities of an organization over a period of time” fiscal.
Integration, cooperation and partnerships
Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 18: Design Considerations for Healthcare Information Systems Chapter 18:
Alternative Perspectives on Corporate Social Responsibility (CSR) in the UK National Government, Business and Higher Education Academies Miss Ya-Ting (Nancy)
Dr Daniel Birchall, Consultant Neuroradiologist and Chair of the Information Systems Strategy Board Newcastle Upon Tyne Hospitals NHS Foundation Trust.
Research and Development Dr Julie Hankin Medical Director.
1 Introduction to Safety Management April Objective The objective of this presentation is to highlight some of the basic elements of Safety Management.
Produced by The Alfred Workforce Development Team on behalf of DHS Public Health - Diabetes Prevention and Management Initiative June 2005 Recall and Reminder.
1 Data use, data sharing and information governance Geraint Lewis Chief Data Officer, NHS England Mark Golledge Programme Manager in.
Spring ÇGIE398 - lecture 10 SSM in detail1.
Open Data Platform Supplier Forum 13 January 2012.
Chapter 12 Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser.
Shared Responsibility in Action- Whole Family Teams August 2012.
UNIT-II Chapter : Software Quality Assurance(SQA)
Interoperability and Information Sharing Keith Naylor (DHID Tech Office)
Action Research EDUU 604 Dr. Ray Gen.
Health eDecisions Use Case 2: CDS Guidance Service Strawman of Core Concepts Use Case 2 1.
Information Risk Management Key Component for HIPAA Security Compliance Ann Geyer Tunitas Group
© 2017 SlidePlayer.com Inc. All rights reserved.