Impact of electronic health record systems on health professionals’ patterns of clinical work
Evidence regarding how the use of clinical information systems influence patterns of clinical work and support efficient work practices is limited. While there is great enthusiasm regarding the ways in which information technologies might streamline clinical work processes and free health professionals from administrative tasks, allowing them great time in direct care activities, there is very limited empirical evidence to demonstrate whether such outcomes are achieved. Changes in distribution of work tasks have been found. For example in the United States where nurses are usually required to transcribe handwritten medication orders, computerized systems eliminate this task.
A small number of overseas researchers have also shown that communication patterns between health professionals change with less opportunities for face-to-face communication. Little is known about the implications of these changes in work and communication patterns. However until we have better quality data about how systems enhance or disrupt existing patterns of clinical work and communication we cannot move to re-design work practices or systems in ways which avoid any possible negative outcomes. To do this we need to observe clinical practice in progress.
We are conducting modified time and motion studies of doctors, nurses and pharmacists to measure changes in the time spent in specific work tasks before and after the introduction of electronic medication management systems in hospitals. This has included ground-breaking work in testing different work measurement techniques and designing new work measurement study data collection tools using handheld computers (PDAs) which are able to collect data which reflect the complexity of clinical work.
This program of work aims to:
- Examine and measure patterns of work and communication including face-to face interactions as well as interruptions and multi or parallel tasking.
- Develop and apply methods for measuring how clinicians distribute their time across work tasks and how this changes following introduction of a clinical information system.
Lead Researcher: Professor Johanna Westbrook
Research Funding: ARC Linkage grant in partnership with NSW Health 2003-2007
Collaborators:
- Concord Repatriation General Hospital, Sydney
- Centre for Health Informatics University of NSW