3,365 research outputs found

    Collaborative Affordances of Medical Records

    Get PDF

    Collaborative Affordances of Medical Records

    Get PDF
    This article proposes the concept of Collaborative Affordances to describe physical and digital properties (i.e., affordances) of an artifact, which affords coordination and collaboration in work. Collaborative Affordances build directly on Gibson (1977)’s affordance concept and extends the work by Sellen and Harper (2003) on the affordances of physical paper. Sellen and Harper describe how the physical properties of paper affords easy reading, navigation, mark-up, and writing, but focuses, we argue, mainly on individual use of paper and digital technology. As an extension to this, Collaborative Affordances focusses on the properties of physical and digital artifacts that affords collaborative activities. We apply the concept of Collaborative Affordances to the study of paper-based and electronic patient records in hospitals and detail how they afford collaboration through four types of Collaborative Affordances; being portable across patient wards and the entire hospital, by providing collocated access, by providing a shared overview of medical data, and by giving clinicians ways to maintain mutual awareness. We then discuss how the concept of Collaborative Affordances can be used in the design of new technology by providing a design study of a ‘Hybrid Patient Record’ (HyPR), which is designed to seamlessly blend and integrate paper-based with electronic patient records

    STS in management education: connecting theory and practice

    Get PDF
    This paper explores the value of science and technology studies (STS) to management education. The work draws on an ethnographic study of second year management undergraduates studying decision making. The nature and delivery of the decision making module is outlined and the value of STS is demonstrated in terms of both teaching method and module content. Three particular STS contributions are identified and described: the social construction of technological systems; actor network theory; and ontological politics. Affordances and sensibilities are identified for each contribution and a discussion is developed that illustrates how these versions of STS are put to use in management education. It is concluded that STS has a pivotal role to play in critical management (education) and in the process offers opportunities for new forms of managin

    Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method

    Get PDF
    Background: The extensive and rapidly expanding research literature on electronic patient records (EPRs) presents challenges to systematic reviewers. This literature is heterogeneous and at times conflicting, not least because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Aim: To map, interpret and critique the range of concepts, theories, methods and empirical findings on EPRs, with a particular emphasis on the implementation and use of EPR systems. Method: Using the meta-narrative method of systematic review, and applying search strategies that took us beyond the Medline-indexed literature, we identified over 500 full-text sources. We used ‘conflicting’ findings to address higher-order questions about how the EPR and its implementation were differently conceptualised and studied by different communities of researchers. Main findings: Our final synthesis included 24 previous systematic reviews and 94 additional primary studies, most of the latter from outside the biomedical literature. A number of tensions were evident, particularly in relation to: [1] the EPR (‘container’ or ‘itinerary’); [2] the EPR user (‘information-processer’ or ‘member of socio-technical network’); [3] organizational context (‘the setting within which the EPR is implemented’ or ‘the EPR-in-use’); [4] clinical work (‘decision-making’ or ‘situated practice’); [5] the process of change (‘the logic of determinism’ or ‘the logic of opposition’); [6] implementation success (‘objectively defined’ or ‘socially negotiated’); and [7] complexity and scale (‘the bigger the better’ or ‘small is beautiful’). Findings suggest that integration of EPRs will always require human work to re-contextualize knowledge for different uses; that whilst secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper, far from being technologically obsolete, currently offers greater ecological flexibility than most forms of electronic record; and that smaller systems may sometimes be more efficient and effective than larger ones. Conclusions: The tensions and paradoxes revealed in this study extend and challenge previous reviews and suggest that the evidence base for some EPR programs is more limited than is often assumed. We offer this paper as a preliminary contribution to a much-needed debate on this evidence and its implications, and suggest avenues for new research

    Occasioning Dialogic Spaces of Innovation: The pan-Canadian EHR, Infoway and the Re-Scripting of Healthcare

    Get PDF
    The Canadian public healthcare system appears to currently be under considerable strain. Escalating costs, dwindling budgets and growing patient dissatisfaction are just a few of the systemic pressures that have called into question our current ways of delivering healthcare. As a consequence, there is a growing recognition that renewal is needed, and that this renewal, to be successful, should meet the needs of a wide array of stakeholders, hence calling for unprecedented levels of collaboration among increasingly fragmented interests. In order to bring about this renewal, the federal government seems to be intent on implementing a pan-Canadian electronic health record (EHR) system. To that end, in 2001, Canada Health Infoway was born out of a novel collaboration between federal and jurisdictional health ministries with the specific mandate to accelerate the implementation of EHRs across Canada. In this thesis, I use material-semiotic and dialogic approaches to gain a more nuanced understanding of how the pan-Canadian EHR system is unfolding and in what ways Infoway is trying to accelerate that unfolding. I conclude by suggesting that a more dialogic approach to innovating, in which the innovator focuses on finding various ways to occasion dialogic spaces, may better foster the creation of new meanings of the innovation and therefore result in a more, and not less, harmonious change process. Furthermore, through these dialogic spaces, it is not just multiple meanings of the innovation that are being occasioned, but the innovation itself seems to become more meaningful

    An Activity-Centric Approach to Configuration Work in Distributed Interaction

    Get PDF
    The widespread introduction of new types of computing devices, such as smartphones, tablet computers, large interactive displays or even wearable devices, has led to setups in which users are interacting with a rich ecology of devices. These new device ecologies have the potential to introduce a whole new set of cross-device and cross-user interactions as well as to support seamless distributed workspaces that facilitate coordination and communication with other users. Because of the distributed nature of this paradigm, there is an intrinsic difficulty and overhead in managing and using these kind of complex device ecologies, which I refer to as configuration work. It is the effort required to set up, manage, communicate, understand and use information, applications and services that are distributed over all devices in use and people involved. Because current devices and their containing software are still document- and application-centric, they fail to capture and support the rich activities and context in which they are being used. This leaves users without a stable concept for cross-device information management, forcing them to perform a large amount of manual configuration work. In this dissertation, I explore an activity-centric approach to configuration work in distributed interaction. The central goal of this dissertation is to develop and apply concepts and ideas from Activity-Centric Computing to distributed interaction. Using the triangulation approach, I explore these concepts on a conceptual, empirical and technological level and present a framework and use cases for designing activitycentric configurations in multi-device information systems. The dissertation presents two major contributions: First, I introduce the term configuration work as an abstract analytical unit that describes and captures the problems and challenges of distributed interaction. Using both empirical data and related work, I argue that configuration work is composed of: curation work, task resumption lag, mobility work, physical handling and articulation work. Using configuration work as a problem description, I operationalize Activity Theory and Activity-Centric Computing to mitigate and reduce configuration work in distributed interaction. By allowing users to interact with computational representations of their real-world activities, creating complex multi-user device ecologies and switching between cross-device information configurations will be more efficient, more effective and provide better support for users’ mental model about a multi-user and multi-device environment. Using activity configuration as a central concept, I introduce a framework that describes how digital representations of human activity can be distributed, fragmented and used across multiple devices and users. Second, I present a technical infrastructure and four applications that apply the concepts of activity configuration. The infrastructure is a general purpose platform for the design, development and deployment of distributed activitycentric systems. The infrastructure simplifies the development of activity-centric systems as it presents complex distributed computing processes and services into high level activity system abstractions. Using this infrastructure and conceptual framework, I describe four fully working applications that explore multi-device interactions in two specific domains: office work and hospital work. The systems are evaluated and tested with end-users in a number of lab and field studies

    Sabbatical as a part of the academic excellence journey: A narrative qualitative study.

    Full text link
    INTRODUCTION: Sabbaticals were first offered by Harvard University in the late 17th century to provide "renewal" for faculty members. In this period of career development, a professor might learn new techniques, expand a research program, or finish off that book or pile of languishing manuscripts. This article tried to organize lived experiences of a visiting scholar from Isfahan University of Medical Sciences to Johns Hopkins University. The research aimed to study the context and conditions of the sabbatical in an alternative academic setting. METHODS: This article applies a narrative qualitative study integrated with Eisner critical and connoisseurship approach as a combined naturalistic methodology. Using narrative inquiry and reflective analysis in form of observations and audit reports, written dairy notes and memos, the content analyzed thematically and extracted the themes of lived experiences as well as lessons learned and then have been transformed into tables. RESULTS: Extracted themes from research sources are categorized into three main themes: organizational and professional experiences; teaching, instruction, and curricular experiences; and research and technology management experiences. These are resulted in the explanation of the field and events (description), discussion about them (interpretation), followed by concluding remarks (evaluation). It also represents research questions and findings in descriptive and interpretation phases. DISCUSSION AND CONCLUSIONS: This article addresses some descriptions, interpretations, and evaluations extracted from the experiences through answering the research questions. It categorizes these practical lessons into three categories: (1) lessons about becoming a lifelong learner, (2) lessons about remaining a professor, and (3) innovative experiences
    • …
    corecore