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Methods Inf Med 2003; 42(04): 376-384
DOI: 10.1055/s-0038-1634233
Original article
Schattauer GmbH

Order Creation and Communication in Healthcare

P. N. Gorman
1   Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University, Portland, OR, USA
,
M. B. Lavelle
1   Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University, Portland, OR, USA
,
J. S. Ash
1   Department of Medical Informatics and Clinical Epidemiology Oregon Health & Science University, Portland, OR, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
08 February 2018 (online)

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Summary

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.

Keywords

Computerized physician order entry (CPOE) - human computer interaction - social informatics - distributed cognition
 

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