In the age of the smart machine: the future of work and power
In the age of the smart machine: the future of work and power
Aspects of the computer-based patient record
Aspects of the computer-based patient record
Process innovation: reengineering work through information technology
Process innovation: reengineering work through information technology
Strategy and Architecture of Health Care Information Systems
Strategy and Architecture of Health Care Information Systems
Patient Care Information Systems: Successful Design and Implementation
Patient Care Information Systems: Successful Design and Implementation
A nursing perspective to design and implementation of electronic patient record systems
Journal of Biomedical Informatics - Special issue: Building nursing knowledge through infomatics: from concept representation to data mining
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Reengineering of the workplace through Information Technology is an important strategic issue for today's hospitals. The computer-based patient record (CPR) is one technology that has the potential to profoundly modify the work routines of the care unit. This study investigates a CPR project aimed at allowing physicians and nurses to work in a completely electronic environment. The focus of our analysis was the patient nursing care process. The rationale behind the introduction of this technology was based on its alleged capability to both enhance quality of care and control costs. This is done by better managing the flow of information within the organization and by introducing mechanisms such as the timeless and spaceless organization of the work place, de-localization, and automation of work processes. The present case study analyzed the implementation of a large CPR project ($45 million U.S.) conducted in four hospitals in joint venture with two computer firms. The computerized system had to be withdrawn because of boycotts from both the medical and nursing personnel. User-resistance was not the problem. Despite its failure, this project was a good opportunity to understand better the intricate complexity of introducing technology in professional work where the usefulness of information is short lived and where it is difficult to predetermine the relevancy of information. Profound misconceptions in achieving a tighter fit (synchronization) between care processes and information processes were the main problems.