Research Article | Open Access
Practitioner-Customizable Clinical Information Systems: A Case Study to Ground Further Research and Development Opportunities
The uptake of electronic records and information technology support in intensive care medicine has been slower than many people predicted. One of the engineering challenges to overcome has been the subtle, but important, variation in clinical practice in different units. A relatively recent innovation that addresses this challenge is practitioner-customizable clinical information systems, allowing clinicians wide scope in adjusting their systems to suit their clinical practice. However, these systems present a significant design challenge, not only of added technical complexity, but in providing tools that support clinicians in doing many of the tasks of a software engineer. This paper reviews the use of a commercially available clinical information system that is intended to be practitioner-customizable, and considers the further design and development of tools to support healthcare practitioners doing end-user customization on their own clinical information systems.
- A. J. Sellen and R. H. R. Harper, The Myth of the Paperless Office, MIT Press, Boston, 2002.
- D. Martin, R. Procter, J. Mariani, and M. Rouncefield, “Working the Contract,” in Proceedings of OzCHI, pp. 241–248, 2007.
- C. Morrison and A. F. Blackwell, “Observing end-user customisation of electronic patient records,” in Proc. 2nd International Symposium on End-User Development, IS-EUD'09, V. Pipek, M.-B. Rosson, B. de Ruyter, and V. Wulf, Eds., (Lecture Notes in Computer Science - LNCS 5435), pp. 275–284, Springer Verlag, 2009.
- Metavision ICU, http://www.imd-soft.com/metavision-for-icus.
- PatientOS - an open source health information system, http://www.patientos.org/.
- OpenEHR, http://www.openehr.org/home.html.
- H. Lieberman, F. Paterno, and V. Wulf, Eds., End User Development - Empowering people to flexibly employ advanced information and communication technology, Kluwer Publishers, Dordrecht, The Netherlands, 2006.
- C. Morrison, M. Jones, A. Blackwell, and A. Vuylsteke, “Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff,” Critical Care, vol. 12, p. R148, 2008.
- J. C. Johnson and S. C. Weller, “Elicitation Techniques for Interviewing,” in Handbook of Interview Research: Context and Method, J. F. Gubrium and J. A. Holstein, Eds., pp. 491–514, Sage, London, 2001.
- N. Miyake, “Constructive interaction and the iterative process of understanding,” Cognitive Science, vol. 10, pp. 151–177, 1986.
- H. Kahler, M. Muller, and F. Kensing, “Methods & tools: constructive interaction and collaborative work: introducing a method for testing collaborative systems,” Interactions, vol. 7, pp. 27–34, 2000.
- E. Manias and A. Street, “Nurse-doctor interactions during critical care ward rounds,” J Clin Nurs, vol. 10, pp. 442–450, 2001.
- J. T. Scott, T. G. Rundall, T. M. Vogt, and J. Hsu, “Kaiser Permanente's experience of implementing an electronic record: a qualitative study,” BMJ, vol. 331, pp. 1313–1316, 2005.
- R. S. Pressman, Software engineering, McGraw-Hill, Columbus, 2008.
- G. Pahl, W. Beitz, J. Feldhusen, and K. H. Grote, Engineering Design: a systematic approach, Springer, London, 3rd edition, 2007.
- T. R. G. Green, “The cognitive dimension of viscosity: a sticky problem for HCI,” in Human-Computer Interaction-INTERACT' 90, D. Diaper, D. Gilmore, G. Cockton, and B. Shackel, Eds., Elsevier, Amsterdam, 1990.
- M. M. Habraken, T. W. Van der Schaaf, I. P. Leistikow, and P. M. Reijnders-Thijssen, “Risk management: Prospective risk analysis of health care processes: a systematic evaluation of the use of HFMEA in Dutch health care,” Ergonomics, vol. 52, no. 7, pp. 809–19, 2009.
- C. A. Ericson II, Hazard Analysis Techniques for System Safety, John Wiley & Sons, New Jersey, 2005.
- A. F. Blackwell, L. Church, and T. R. G. Green, “The abstract is ‘an enemy’: Alternative perspectives to computational thinking,” in Proceedings PPIG'08, 20th annual workshop of the Psychology of Programming Interest Group, pp. 34–43, 2008.
- L. Beckwith, C. Kissinger, B. Burnett et al., “Tinkering and gender in end-user programmers' debugging,” in Proceedings of CHI, pp. 231–240, 2006.
- L. L. Bucciarelli, Designing Engineers, MIT Press, Boston, 2006.
- M. Burnett, C. Cook, and G. Rothermel, “End-User Software Engineering,” Communications of the ACM, vol. 47, no. 9, pp. 53–58, 2004.
- J. M. Carroll and M. B. Rosson, “Paradox of the active user,” in Interfacing Thought: Cognitive Aspects of Human-Computer Interaction, J. M. Carroll, Ed., pp. 80–111, Bradford Books/MIT Press, 1987.
- A. F. Blackwell and M. Burnett, “Applying Attention Investment to end-user programming,” in Proceedings of the IEEE Symposia on Human-Centric Computing Languages and Environments, pp. 28–30, 2002.
- S. Tanimoto, “VIVA: A Visual Language for Image Processing,” Journal of Visual Languages and Computing, vol. 1, no. 2, pp. 127–139, 1990.
- C. Bessière, Utiliser les contraintes sans rien y comprendre, Presentation at Reconnaissance des Formes et Intelligence Artificielle RFIA 2008, http://www.mis.upicardie.fr/rfia2008/index.php?id_page=20.
- A. J. Ko, R. Abraham, L. Beckwith et al., The State of the Art in End-User Software Engineering. Accepted for publication in ACM Computing Surveys.
- A. Wilson, M. Burnett, L. Beckwith et al., “Harnessing curiosity to increase correctness in end-user programming,” in Proceedings of the SIGCHI conference on Human factors in computing systems, 2003.
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