P N Gorman1, M B Lavelle, J S Ash. 1. Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239-3098, USA. gormanp@ohsu.edu
Abstract
OBJECTIVES: The aim of this paper is to examine the adequacy of the concept of Physician Order Entry (POE) as a model for clinical systems, and to suggest an alternative understanding of the order creation and communication process. METHODS: The study is based on an interpretative analysis of POE as a model for clinical systems and the results of our recent fieldwork. RESULTS: Observations from our recent fieldwork suggest that orders, like patient care in general, emerge from interactions among patients, physicians, nurses, family members, and others, employing a variety of technologies and information resources in the process. Orders as we have observed them originate, are negotiated, and are carried out in a dynamically evolving group with fluctuating membership and shifting role responsibilities. Furthermore, orders by themselves represent only a partial picture of what is done for the patient. CONCLUSION: We argue that information systems are more likely to be helpful if they accommodate and facilitate POE as a multidisciplinary collaboration effort and fit better into the larger system of patient care.
OBJECTIVES: The aim of this paper is to examine the adequacy of the concept of Physician Order Entry (POE) as a model for clinical systems, and to suggest an alternative understanding of the order creation and communication process. METHODS: The study is based on an interpretative analysis of POE as a model for clinical systems and the results of our recent fieldwork. RESULTS: Observations from our recent fieldwork suggest that orders, like patient care in general, emerge from interactions among patients, physicians, nurses, family members, and others, employing a variety of technologies and information resources in the process. Orders as we have observed them originate, are negotiated, and are carried out in a dynamically evolving group with fluctuating membership and shifting role responsibilities. Furthermore, orders by themselves represent only a partial picture of what is done for the patient. CONCLUSION: We argue that information systems are more likely to be helpful if they accommodate and facilitate POE as a multidisciplinary collaboration effort and fit better into the larger system of patient care.
Authors: Joan S Ash; Dean F Sittig; Veena Seshadri; Richard H Dykstra; James D Carpenter; P Zoe Stavri Journal: Int J Med Inform Date: 2005-08 Impact factor: 4.046
Authors: Charlene R Weir; Jonathan J R Nebeker; Bret L Hicken; Rebecca Campo; Frank Drews; Beth Lebar Journal: J Am Med Inform Assoc Date: 2006-10-26 Impact factor: 4.497