Sociotechnical Requirements Analysis for Clinical Systems

M. Reddy Ph.D.; W. Pratt Ph.D.; P. Dourish Ph.D.; M. M. Shabot M.D.

doi:10.1055/s-0038-1634346

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2003; 42(04): 437-444
DOI: 10.1055/s-0038-1634346

Original article

Schattauer GmbH

Sociotechnical Requirements Analysis for Clinical Systems

M. Reddy Ph.D.

¹School of Management and Information Systems, University of Missouri-Rolla, Rolla, MO, USA

,

W. Pratt Ph.D.

²Division of Biomedical & Health Informatics and the Information School, University of Washington, Seattle, WA, USA

,

P. Dourish Ph.D.

³School of Information and Computer Science, University of California-Irvine, Irvine, CA, USA

,

M. M. Shabot M.D.

⁴Departments of Surgery and Enterprise Information Systems, Cedars-Sinai Medical Center, Los Angeles, CA, USA

› Author Affiliations

Abstract

Summary

Objective: We explore sociotechnical requirements by examining the use of a computerized patient record system in an intensive care unit of a U.S. hospital and present two sociotechnical requirements, awareness and coordination, embedded in the users’ work.

Method: The study is based on observation during seven months of the use of a computerized patient record system in a surgical intensive care unit. During that period semi-formal interviews, informal interviews were held.

Results and Conclusions: A key step in the design of clinical systems is the development and analysis of requirements. However, traditional requirements analysis is based on a set of assumptions that break down in the highly collaborative, exception-filled clinical domain. Sociotechnical requirement analysis enabled the designers to gather a much richer description of the environment surrounding the computer system, highlighting awareness and coordination, embedded in the users’ work.

Keywords

Sociotechnical requirements analysis - clinical systems - computerized patient record system - collaborative work - intensive care unit

Full Text

References

References
1 Robertson S, Robertson J. Mastering the requirements process. Menlo Park: ACM Press; 1999
2 The Standish Group. The Chaos Report. [Online]. 1994 [cited 2001]. Available from URL: www.pm2go.com/sample_research/chaos_1994_1.asp
3 Travers DA, Downs SM. Comparing user acceptance of a computer system in two pediatric offices: a qualitative study. Proc AMIA Symp 2000; 853-7.
4 Barley SR. Technology as an occasion for structuring: evidence from observations of CT scanners and the social order of radiology departments. Administrative Science Quarterly, 1986; 31: 78-108.
5 Heath C, Luff P. Documents and professional practice,‘bad’ organisational reasons for ‘good’ clinical records. ACM Conference on Computer-Supported Cooperative Work 1996; 354-63.
6 Goddard BL. Termination of a Contract to Implement an Enterprise Electronic Medical Record System. J Am Med Inf Assoc 2000; 7: 564-8.
7 Jirotka M, Goguen J. Requirements engineering, social and technical Issues. San Diego: Academic Press Limited; 1994
8 Daley E. Management of software development. IEEE Transactions on Software Engineering 1997; 3: 229-42.
9 Boehm BW. Software Engineering. IEEE Transactions on Software Engineering 1976; 1: 1226-41.
10 Jackson M. Software requirements and specifications. Menlo Park: Addison-Wesley; 1999
11 NCC. The STARTS Purchasers’ Handbook. UK: NCC; 1989
12 McDermid JA. Requirements analysis: Orthodoxy, fundamentalism, and heresy. In: M. Jirotka M, Gougen J. editors. Requirements engineering, social and technical issues. San Diego: Academic Press; 1994. pp. 17-40.
13 Gougen JA, Linde C. Techniques for requirements elicitation. IEEE Conference on Requirements Engineering 1999; 152-64.
14 Baggs JG. Intensive care unit use and collaboration between nurses and physicians. Heart Lung 1989; 18: 332-8.
15 Berg M. Patient care information systems and health care work: a sociotechnical approach. Int J Med Inf 1999; 55: 87-101.
16 Forsythe DE, Buchanan BG, Osheroff JA, Miller RA. Expanding the concept of medical information, an observational study of physicians’ information needs. Computers and Biomedical Research 1992; 25: 181-200.
17 Baggs JG, Schmitt MH, Mushlin AI, Mitchell PH, Eldredge DH, Oakes D, Hutson AD. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med 1999; 27: 1991-8.
18 Symon G, Long K, Ellis J. The Coordination of work activities: cooperation and conflict in a hospital context. Comp Supp Coop Work 1996; 5: 1-31.
19 Katzenberg B, Pickard F, McDermott J. Computer support for clinical practice: embedding and evolving protocols of care. ACM Conference on Computer Supported Cooperative Work 1996
20 Berg M, Langenberg C vd Berg, Kwakkernaat JK. Considerations for sociotechnical design, experiences with an electronic patient record in a clinical context. Int J Med Inf 1998; 52: 243-51.
21 Strauss A, Fagerhaugh S, Suczek B, Wiener C. Social organization of medical work. Chicago: University of Chicago Press; 1985
22 Bikson T, Eveland J. Groupware implementation, reinvention in the sociotechnical frame. ACM Conference on Computer Supported Cooperative Work 1996; 428-37.
23 Viller S, Sommerville I. Social analysis in the requirements engineering process: from ethnography to method. IEEE Conference on Requirements Engineering 1999; 6-13.
24 Sommerville I, Rodden T, Sawyer P, Bentley R, Twidale M. Integrating ethnography into the requirements engineering process. Requirements Engineering 1992; 165-73.
25 Bentley R, Hughes JA, Randall D, Rodden T, Sawyer P, Shapiro D, Summerville I. Ethno-graphically-informed systems design for air traffic control. ACM Conference on Computer Supported Cooperative Work 1992; 123-29.
26 Heath C, Luff P. Collaboration and control: crisis management and multimedia technology in London Underground line control rooms. Comp Supp Coop Work 1992; 1: 69-118.
27 Hughes J, King V, Rodden T, Anderson H. Moving out of the control room, ethnography in system design. ACM Conference on Computer Supported Cooperative Work 1994; 429-39.
28 Sommerville I. Software engineering. San Francisco: Addison-Wesley; 2001
29 Berg M. Accumulating and coordinating, occasions for information technologies in medical work. Journal of Computer Supported Cooperative Work 1999; 8: 373-401.
30 Forsythe DE. Using ethnography to investigate life scientists’ information needs. Bulletin of Medical Library Association 1998; 86: 402-9.
31 Hughes JA, Randall D, Shapiro D. Faltering from ethnography to design. ACM Conference on Computer Supported Cooperative Work 1992; 115-22.
32 Shabot MM. The HP CareVue clinical information system. International Journal of Clinical Monitoring Computing 1997; 14: 177-84.
33 Dourish P, Bellotti V. Awareness and Coordination in Shared Workspaces. ACM Conference on Computer Supported Cooperative Work 1992; 107-14.
34 Bricon-Souf N, Renard JM, Beuscart R. Dynamic workflow model for complex activity in intensive care unit. Medinfo 1998; 9: 227-31.
35 Berg M, Bowker G. The multiple bodies of the medical record, toward a sociology of an artifact. The Sociological Quarterly 1997; 38: 511-35.
36 Malone TW, Crowston K. The interdisciplinary study of coordination. ACM Computing Surveys 1994; 26: 87-119.