health care information systems

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Int J Med Inform. 1999 Aug;55(2):87-101.

Patient care information systems and health care work: a
sociotechnical approach.
========================================================

Berg M.

Institute of Health Policy and Management, Erasmus University
Rotterdam, The Netherlands. m.berg@bmg.eur.nl

Abstract

Those who face the difficulties of developing useful patient care
information systems (PCISs) often stress the importance of
'organizational issues'. Building upon recent sociological insights in
the construction and use of information technologies for (health care)
work, this paper underscores the importance of these insights for the
development and evaluation of these systems. A sociotechnical approach
to PCISs in health care is outlined, and two implications of this
empirically grounded approach for the practices of developing and
evaluating IT applications in health care practices are discussed.
First, getting such technologies to work in concrete health care
practices appears to be a politically textured process of
organizational change, in which users have to be put at center-stage.
This requires an iterative approach, in which the distinctions between
'analysis', 'design', 'implementation' and 'evaluation' blur. Second,
a sociotechnical approach sheds new light on the potential roles of IT
applications in health care practices. It is critical of approaches
that denounce the 'messy' and 'ad hoc' nature of health care work, and
that attempt to structure this work through the formal, standardized
and 'rational' nature of IT systems. Optimal utilization of IT
applications, it is argued, is dependent on the meticulous
interrelation of the system's functioning with the skilled and
pragmatically oriented work of health care professionals.

PMID: 10530825 PubMed - indexed for MEDLINE

Publication Types, MeSH Terms
-----------------------------

Publication Types:

Research Support, Non-U.S. Gov't

MeSH Terms:

Information Systems/organization & administration

Patient Care

Sociology

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