in qualitative analysis, 67 shared and information systems,
70–71
Artificial intelligence, 334 ASP (Active Server Pages), 140 Assessment tests, 152
Audio-based data, software analysis of, 160–161
B
Background questionnaires, 155–156 Behavioral Scale, 80
Billing, respiratory care computer system, 322–323
Bush, George W., 335
C
CareVue system, 61–71
collaboration, support of, 62–65 and medication administration,
62–64
morning rounds notes in, 62
multiple perspectives provided by, 70 and shared artifacts, 70–71
and shared awareness of teams, 69–70
and workflow dependencies, 68–69 Causal processes, qualitative
investigation of, 33 Change Scale, 80 Charting
automatic versus manual, 320–321, 325
respiratory care computer system, 315–332
Index
A
Admission, Discharge, and Transfer (ADT) system, 88
Adverse drug effect prevention simulation, 215–218, 280–291 automated medication dispensing
system, 284
comprehensive medication delivery system, 284–285
drug delivery system flowchart, 217 pharmacy stage, 284
physician order entry stage, 283–284 prescribing stage, 283
prevention strategies, effects of, 288–289
Adverse drug effects cost of, 276
death, prevalence of, 276 definition of, 276
prevention. See Adverse drug effect prevention simulation
primary cause of, 276 reporting issue, 276–277
systems approach to study of, 277 Alert reports, 322–323
American Medical Informatics Association (AMIA), 335 Analysis of variance (ANOVA)
social network analysis, 196 work-sampling study, 183 Analytical processes, 149
Analytic memos, qualitative methods, 42, 48–49
Artifacts meaning of, 67
337
Chi-square test, work-sampling study, 183
Classification, in qualitative methods, 67–68
Cluster analysis, social network analysis, 192–194
Coding
cognitive evaluation of systems, 160–162
qualitative studies, 41–42, 49, 67 Cognitive concepts
cognitive continuum, 148–149 cognitive task analysis (CTA), 150 in human-computer interaction,
151–152
usability engineering, 151 usability testing, 151 Cognitive continuum, 148–149 Cognitive evaluation of systems, 144,
148–170
in artificial conditions, 166–168 background questionnaire selection,
155–156
coding categories, 160–162 CPR system example, 164–165 data collection, 156–159
evaluation environment selection, 156
findings, integration into design, 163 future view of, 169–170
health information system application, 165–166 interpretation of findings, 163 in naturalistic conditions, 168–169 objectives of, 153
process data, analysis of, 159–163 representative task/context selection,
155
sample selection, 153–154 study design, 154
think-aloud reports, 157–159 Cognitive structure survey, 83–84 Cognitive style, survey of, 83 Cognitive task analysis (CTA), 150 Communication
and consulting room information systems, 245–246
interdepartmental, survey on, 126 Comparison tests, 153
CompuHx, 230–247
and clinical communication, 245–246
and depersonalization of care, 239 examiner attitudes toward, 234–235 examiner demographic data, 234 examiner surveys of, 231 impacts of use on examiners,
241–243
implementation of system, 231 interviews with examiners, 231–232 and job performance, 235–236 limitations of study, 243–244 patient demographic data, 241 and patient satisfaction, 246–247 patient surveys, 233–234
predictors of attitudes toward, 235, 237
quality control, 239
social network analysis of use, 197–200, 232–233, 239–241 stored information, types of, 230 system champion, role of, 245 thoroughness of system, 238 time spent using, 239
and uncertainty in patient care, 237–238
Computerized physician order entry (CPOE). See Physician order entry system
Computer-mediated collaborative design, social network analysis of, 200–202
Computers
and decision making, 85 impacts on work, 84
systems, user resistance and failure, 30
Computer simulation, 205–218 advantages of, 208
of adverse drug effect prevention.
See Adverse drug effect prevention simulation
data collection, 206–207, 278–279 defined, 206
model formulation, 207–208, 280–281
model validation, 208
of physician order entry, 212–215
sensitivity analysis on model, 208, 287–288
STELLA, 275, 280 systems analysis, 206
of wide-area healthcare network, 209–212
Concept maps, in qualitative methods, 42–43
Confidentiality, Internet-based research, 131, 133
Consulting room information systems, 225–247
of CompuHx, 230–247
and depersonalization of care, 239, 246–247
early studies, 228 extent of use, 225–226
in health appraisal setting, 229–230 social network analysis, 197–200 working style changes, 228 Contextual analysis, in qualitative
methods, 43, 49
Control charts, work-sampling study, 181–182
Control and computerization, survey on, 86–87
Cookies, in Internet-based research, 139 CVideo, 159
D
Data analysis
grounded theory, 49, 67
qualitative methods, 41–43, 67–68 software tools, 43
work-sampling study, 182–183 Data collection
artifact collection, 67
cognitive evaluation of systems, 156–159
computer simulation, 206–207, 278–279
interviews, 40, 66 observation, 39, 66 qualitative methods, 38–39 social network analysis, 191 work-sampling study, 178–182 Decision events, 150
Decision-making ability, survey of, 84–86
cognitive continuum, 148–149 defined, 84
Departmental records, review for productivity, 176–177
Dependencies, and team work, 68–69 Depersonalization of care, and
consulting room information system, 239, 246–247
Displays, in qualitative methods, 42–43, 49
Documentation, nurses, work-sampling study, 304–312
Double charting, 305, 311 E
Electronic medical records (EMR) and double charting, 305, 311 functions of, 56
lack of success, reasons for, 304–305 nursing documentation time, work-
sampling study, 304–312
E-mail, for survey administration, 134 Employee adaptation, survey on,
116–118
End-User Computing Satisfaction survey, 78, 104–105
Ethical issues, Internet-based research, 131–133
Ethnography elements of, 49, 65
See also Qualitative methods Exploratory tests, 152
F
Feedback, qualitative methods, 45, 49 Flowcharts, in qualitative methods,
42–43
Focus groups, qualitative methods, 40 Formative evaluation, qualitative
approach, 33, 49, 130
Free-text data entry, respiratory care computer system, 330
G
Grounded theory, data analysis, 49, 67
H
Hawthorne effect defined, 133
work-sampling study, 184–185
Healthcare information systems clinician acceptance, factors in,
226–227
electronic patient record (EPR), 56 future directions, 334–336
optimal system, features of, 315–316 rapid prototyping, 147–148
systems development life cycle, 146–148, 152–153
user-centered systems, 147 Healthcare information systems
evaluation, 57–71
adverse drug effect prevention simulation, 215–218, 280–291 CareVue system, 61–71
cognitive approaches, 144, 148–170 computer simulation, 205–218 consulting room information
systems, 197–200, 225–247 electronic medical records (EMR),
304–312
evaluation issues, 205–206 objectives of, 144–145
physician order entry system, 252–273 qualitative methods, 30–50, 57, 65–71 quantitative methods, 57
respiratory care computer system, 315–332
social network analysis, 189–202 surveys, 75–95
and team use of system, 58–71 of unintended effects, 145–146 Healthcare teams, 58–71
adaptability of, 59 attributes of, 58
CareVue, use/evaluation of, 61–71 clinical teams, 59
context of technology use, 60–61 defined, 58
goals of, 59
group roles in, 58–59 nonclinical teams, 59
surgical intensive care unit (SICU) team, 61–71
Hospital information system (HIS), social network analysis of, 191–196 Human-computer interaction, 151–152
think-aloud reports, 157
Hypotheses, qualitative research, 30 I
Implementation Attitudes Questionnaire, 78, 105–108 Incentives, increasing response rate,
138–139
Inductive method, qualitative research as, 30, 49
Informed consent, Internet-based surveys, 133
Innovation process, survey of, 78–79 InterMed Collaboratory, social
network analysis of use, 200–202 International Medical Informatics
Association (IMIA), 335 Internet-based research, 129–140
cookies, use of, 139
discussion forum postings, 134 e-mail for survey administration,
134
ethical issues, 131–133 examples of, 132
information sources on, 140 interviews, 133–134
invitation-only surveys, 134–135 missing data, tracking of, 140 open surveys, 135
qualitative methodologies, 130 qualitative studies, 129–130 randomizing items, 140
response rate, maximizing, 138–139 response representation, 137–138 response time, measurement of,
139
and selection bias, 136–138 survey administration, 133–135 survey construction tools, 135 televaluation of, 166
validity, 136–138
Interns, physician order entry system use, 258–259
Interviews
Internet-administered, 133–134 list of topics in, 66
open-ended, 40 Intuitive processing, 149
J
Jackson Personality Research Form, 83–84
JavaScript, 140 Job design
research areas, 91 survey on, 126–128
Job enhancement, survey on, 90–92 Job satisfaction, survey on, 128
K
Knowledge continuum, 149
L
Laboratory computer system, survey on, 120–121
Log-file analysis, 133 Lotus Notes, 60
M
MacShapa, 160
Matrices, in qualitative methods, 42–43 Medical education, physician order
entry system, impact of, 258–259, 264–273
Medication
CareVue and team administration of, 62–64
delivery system flowchart, 217, 282 See also Adverse drug effect
prevention simulation; Adverse drug effects; Pharmacy
Member checking, qualitative methods, 45, 49
Mesh topology communication network, 211–212
Modeling. See Computer simulation Morning rounds, by healthcare team,
62
Myers-Briggs Type Indicator, 83
N
Narrative analysis, in qualitative methods, 43
Network of personnel, survey on, 125–126
Nurses
acceptance of systems, factors in, 227
activities, categories of, 306–307 electronic medical records (EMR)
work-sampling study, 304–312
O
Observation. See Participant observation
Open-ended interviews, qualitative research, 40, 49
Open-ended questions, nature of, 40, 50 Open-ended survey, 40
Open surveys, Internet-based, 135 Organizational Information
Technology/Systems Innovation Readiness Scale (OITIRS), 79, 108–111
Orientation toward change survey, 83–84
P
Parsimony, in qualitative analysis, 67 Participant observation
elements of, 39, 130 Internet-based, 130 qualitative methods, 38, 50 research tasks in, 66 PatCIS, 166
Patient satisfaction survey, 118–120 Personal order sets (POSs), 267 Personal records, review for
productivity, 177 Pharmacy
adverse drug effect prevention, 215–218
in computer simulation model, 284 drug order/delivery flowchart, 217,
282
Physician order entry system, 89, 252–273
in computer simulation model, 212–215, 283–284
destabilizing effects, scope of, 255–261, 265–266, 268–273 flowchart of events, 214 functions of system, 254–255 governance/organizational factors,
259–260
impact on medical education, 264–273
impact on work dynamics, 256–257 implementation of, 254–255, 265–267 intern use, 258–259
personal order sets (POSs), 267
Physician order entry system (cont.) type-in pharmacy order problem,
265–266
unsigned verbal order problem, 257–258
Point of care technology, survey on, 111–114
Power relations, shift and computers, 87 Primary sources, in qualitative
methods, 40
Privacy, Internet-based research, 131, 133
Productivity
and respiratory care computer system, 324, 328, 330–332 survey of, 88–89
See also Work evaluation methods PROMIS system, 85
Prototyping defined, 152
prototype testing, 152 rapid, 147–148, 152
Q
Qualitative methods, 30–50 access to setting, 37–38 analytic memos, 42, 48–49 applications, types of, 34–35, 48 classification scheme in, 67–68 coding, 42, 49, 67
combined with qualitative methods, 31
contextual and narrative analysis, 43, 49
data analysis, 41–43, 67–68 data collection, 38–39, 66–67 discrepant data, handing of, 45–46 displays in, 42–43, 49
documents/texts in, 40–41 elements of, 32
feedback, 45, 49 focus groups, 40 goals of, 30, 32–33, 57 hypotheses, 30
as inductive methods, 30, 49 information sources on, 48
Internet-based surveys. See Internet- based research
interpretation cautions, 45
interviews, open-ended, 40 observation, 39
research design, 38 research questions, 35–36 rich data in, 44–45, 50 situations for use, 31 software, uses of, 43 survey, open-ended, 40 terms describing, 32 terms related to, 48–50 theory in, 37
triangulation, 45, 50 units/levels of analysis, 47 validity, 43–47, 50
Quality control, and consulting room information system, 238
Quantitative methods, 57 Quasi-experimental design, social
network analysis, 195–196
R
Randomization
in Internet-based research, 140 work-sampling study, 180, 310 Rapid prototyping, 147–148, 152 Reasoning, cognitive continuum,
148–149
Reliability, defined, 76
Research methods, qualitative, 30–50 Research questions, qualitative
methods, 35–36
Resistance, use of computer systems, 30 Respiratory care computer system,
315–332
automatic routine reporting, 320–322 basic needs, 317
billing, 322–323
charting process, 318–320
charting quality/content evaluation, 324–325
features of, 317–318 free-text data entry, 330 impact of, 328–332
interdepartmental effects, 325 optimal system, features of, 315–316 productivity evaluation, 324, 328,
330–332
therapists’ evaluation of, 323–325 and work patterns, 324–325
Response rate, Internet-based research, 137–138
Rich data, in qualitative methods, 44–45, 50
S
Search engines, and privacy issue, 133 Selection bias
and Internet-based research, 136–138 volunteer effect, 136–137
Self-selection bias, volunteer effect, 136–137
Sensitivity analysis, computer simulation model, 208, 287–288 Simulation. See Computer simulation Social impacts, computers, 84 Social interaction, survey of, 89–90 Social network analysis, 189–202
cluster analysis, 192–194
of computer-mediated collaborative design, 200–202
of consulting room computer use, 197–200, 231–232, 239–241 data collection, 191
HIS use and networks, 191–196 levels of analysis of, 190–191 objectives of, 189–190, 202
quasi-experimental design, 195–196 sociometric analysis, 200–202 Sociometric analysis, of InterMed
Collaboratory, 200–202 Software
for analysis of video/audio-based data, 160–161
data analysis tools, 43
development life cycle, 146–148, 152–153, 168–169
Internet-based survey construction, 135
user-centered design, 147–148 Star topology communication network,
210
STELLA, 275, 280
Subjective evaluations, of work methods, 176
Summative evaluation, qualitative research, 50, 130
Surgical intensive care unit (SICU) team
CareVue use/evaluation, 61–71 goals of, 61–62
medication administration, 62–63 morning rounds, 62–63
team member roles, 61 Surveys, 75–95
Behavioral Scale, 80 Change Scale, 80
on cognitive structure, 83–84 on cognitive style, 83
on consulting room information systems, 233–239
on control and computerization, 86–87
on decision-making ability, 84–86 on employee adaptation, 116–118 End-User Computing Satisfaction
survey, 78, 104–105 goals of, 76
impacts of computers survey, 84 Implementation Attitudes
Questionnaire, 78, 105–108 on individual user attributes, 82 on interdepartmental
communication, 126
Internet-administered. See Internet- based research
items, combining, 81–82 on job design, 126–128 on job enhancement, 90–92 on job satisfaction, 128
on laboratory computer impact, 120–121
on level of system use, 80–81 on network of personnel, 125–126 open-ended surveys, 40
Organizational Information Technology/Systems Innovation Readiness Scale (OITIRS), 79, 108–111
on organizational policies, 79 of organizations, scales adapted
from, 114–115
orientation toward change survey, 83–84
patient survey, 118–120
on point of care technology, 111–114 on productivity, 88–89
on provider-patient interaction, 81
Surveys (cont.)
single-item measures, 79–80 on social interaction, 89–90
User Information Satisfaction Scale, 77–78, 101–104
user satisfaction, situation-specific, 81, 115–116
Use Scale, 80
validity and reliability of, 76 on WatchChild system, 81–82,
122–124
on work environment, 92–93 on work group communication, 79 on work role activities, 125
Systems approach, adverse drug effects study, 277
Systems development life cycle, 146–148
and cognitive evaluation of systems, 152–153, 168–169
T
Teams. See Healthcare teams Televaluation, 166
Theory, and qualitative methods, 37 Think-aloud reports, cognitive
evaluation of systems, 152, 157–159
Thought process recording, in cognitive evaluation of systems, 156–159 Time-motion analysis, 175–176 Transana, 160
Triangulation, qualitative methods, 45, 50
U
Unified Medical Language System, 151
Unintended effects, of IT, 145–146 Usability engineering, 151 Usability testing
cognitive methods. See Cognitive evaluation of systems
purpose of, 151 types of tests, 152–153 User-centered design, 147–148 User satisfaction
situation-specific, 81, 115–116
User Information Satisfaction Scale, 77–78, 101–104
Use Scale, 80
V
Validation tests, 152–153 Validity
defined, 43, 76 external, 136
Internet-based research, 136–138 qualitative methods, 43–47, 50 threats to, 44–45, 50
Video-based data, software analysis of, 160–161
Video recording, in cognitive evaluation of systems, 156–159 Volunteer effect, 136
W
WatchChild, pre-post implementation surveys, 81–82, 122–124
Wide-area healthcare network of computer simulation, 209–212 mesh topology communication
network, 211–212
star topology communication network, 210
Work environment computers, impact of, 84 survey on, 92–93 Work evaluation methods
departmental records review, 176–177
personal records, 177 subjective evaluations, 176 time-motion analysis, 175–176 work-sampling, 177–185
Work groups. See Healthcare teams Work role activities, survey on, 125 Work-sampling, 177–185, 304–312
data analysis, 182–183 data collection, 178–182
electronic medical records (EMR), nursing documentation time, 304–312
pros/cons of, 184–185, 310–311 steps in, 178–183
study conclusions, 183–184
