Browsing by Subject "Electronic health record"

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    Journal Article
    A Worker-Driven Common Information Space: Interventions into a Digital Future
    (Computer Supported Cooperative Work (CSCW): Vol. 29, No. 5, 2020) Møller, Naja Holten; Eriksen, Maren Gausdal; Bossen, Claus
    This paper empirically investigates a Common Information Space (CIS) established by medical secretaries so they could support each other during their workplace’s transition to a new comprehensive electronic health record, called the Healthcare Platform (HP). With the new system, the secretaries were expected to become partially obsolete, as doctors were to take on a significant load of the clerical work, such as documenting and coding. To handle their changing work situation, the medical secretaries set up an online support group in parallel to, but independent from, the official implementation support organization. The paper’s contribution is a characterization of the support group as a common information space (CIS), and analysis of the specific qualities of a worker-driven CIS as a forum for 1) articulation work required for re-grounding changing tasks and responsibilities, 2) archiving discussions (posts) and guidelines to further their collective interpretation, and 3) creating a space independent of management for employees to work out their new role in an organization in a situation of transition and change.
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    Journal Article
    Cooperative Epistemic Work in Medical Practice: An Analysis of Physicians’ Clinical Notes
    (Computer Supported Cooperative Work (CSCW): Vol. 25, No. 6, 2016) Bansler, Jørgen P.; Havn, Erling C.; Schmidt, Kjeld; Mønsted, Troels; Petersen, Helen Høgh; Svendsen, Jesper Hastrup
    We examine an important part of the medical record that has not been studied extensively: physicians’ clinical notes. These notes constitute an explanatory medical narrative that documents the patient’s illness trajectory by combining each physician’s notes into a common text. Although several prior CSCW studies have addressed the role of the medical record in patient care, they have not dealt specifically with the role, structure, and content of these notes. In this article, we present a detailed analysis of a set of physicians’ clinical notes recording the acute hospitalization and subsequent treatment of a patient with chronic heart disease. We show that clinical notes are highly structured and conventionalized texts that promote conciseness while at the same time allowing physicians to express themselves in a precise and nuanced way. Based on this analysis, we argue that physicians’ clinical notes form the core of the medical record. They serve both as a ‘tool for thinking’ for the individual physician, enabling him or her to make sense of the patient’s past history and current condition, and as a coordinative artifact used by physicians, nurses, and other health care professionals. We conclude by discussing the implications of this research for the design of Electronic Medical Record (EMR) systems.
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    Journal Article
    Prescriptions, X-rays and Grocery Lists. Designing a Personal Health Record to Support (The Invisible Work Of) Health Information Management in the Household
    (Computer Supported Cooperative Work (CSCW): Vol. 19, No. 6, 40513) Piras, Enrico Maria; Zanutto, Alberto
    For many years the introduction of Electronic Health Records (EHRs) in medical practice has been considered the best way to provide efficient document sharing among different organizational settings. The actual results of these technologies, though, do not seem to have matched expectations. The issue of document sharing has been lately readdressed by proposing the creation of patient-controlled information and communication technologies, Personal Health Records (PHRs), providing laypeople the tools to access, manage and share their health information electronically by connecting to the existing EHRs and other institutional information systems. In this scenario, patients are called to play a major role in coordinating healthcare professionals by providing them the information they need. From a CSCW perspective the PHR offers an interesting case to reflect on cooperative work that requires new infrastructures that intersect organizational settings and extend into domestic environments. So far though, there has not been enough research to shed light on the self-care activities carried out in the households and how these integrate with the organizational practices of doctors and institutions. Our analyses show that health record keeping is an articulation work necessary for meetings with doctors to proceed smoothly. To do so, people integrate the information contained in medical documents by working on them with annotations, underlinings and integrations. Moreover, we show that health record keeping is a spatialized activity that is inextricably interwoven with the everyday routine and objects. Finally, we provide a tentative classification of three different strategies laypeople use to sort out health records: minimum effort, adaptive, networking.