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Methods Inf Med 2003; 42(03): 203-211
DOI: 10.1055/s-0038-1634245
Original article
Schattauer GmbH

A Generic Model of Clinical Practice

A Common View of Individual and Collaborative Care
H. J. Tange
1   Department of Medical Informatics, Maastricht University
,
J. L. G. Dietz
2   Department of Information Systems, Delft University of Technology
,
A. Hasman
1   Department of Medical Informatics, Maastricht University
,
P. F. de Vries Robbé
3   Department of Medical Informatics, University Medical Centre Nijmegen
› Author Affiliations
Further Information

Publication History

Received 27 February 2002

Accepted 30 October 2002

Publication Date:
07 February 2018 (online)

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Summary

Objectives: Many shared-care projects feel the need for electronic patient-record (EPR) systems. In absence of practical experiences from paper record keeping, a theoretical model is the only reference for the design of these systems. In this article, we review existing models of individual clinical practice and integrate their useful elements. We then present a generic model of clinical practice that is applicable to both individual and collaborative clinical practice.

Methods: We followed the principles of the conversation-for-action theory and the DEMO method. According to these principles, information can only be generated by a conversation between two actors. An actor is a role that can be played by one or more human subjects, so the model does not distinguish between inter-individual and intra-individual conversations.

Results: Clinical practice has been divided into four actors: service provider, problem solver, coordinator, and worker. Each actor represents a level of clinical responsibility. Any information in the patient record is the result of a conversation between two of these actors. Connecting different conversations to one another can create a process view with meta-information about the rationale of clinical practice. Such process view can be implemented as an extension to the EPR.

Conclusions: The model has the potential to cover all professional activities, but needs to be further validated. The model can serve as a theoretical basis for the design of EPR-systems for shared care, but a successful EPR-system needs more than just a theoretical model.

Keywords

Electronic-medical-record - shared-medical-care - clinical-reasoning - communication - process-model
 

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