A model of awareness to enhance our understanding of interprofessional collaborative care delivery and health information system design to support it

BACKGROUND As more healthcare delivery is provided by collaborative teams there is a need for enhanced design of health information systems (HISs) to support collaborative care delivery. The purpose of this study was to develop a model of the different types of awareness that exist in interprofessional collaborative care (ICC) delivery to inform HIS design to support ICC. METHODS Qualitative data collection and analysis was done. The data sources consisted of 90 h of non-participant observations and 30 interviews with nurses, physicians, medical residents, volunteers, and personal support workers. RESULTS Many of the macro-level ICC activities (e.g. morning rounds, shift change) were constituted by micro-level activities that involved different types of awareness. We identified four primary types of ICC awareness: patient, team member, decision making, and environment. Each type of awareness is discussed and supported by study data. We also discuss implication of our findings for enhanced design of existing HISs as well as providing insight on how HISs could be better designed to support ICC awareness. CONCLUSION Awareness is a complex yet crucial piece of successful ICC. The information sources that provided and supported ICC awareness were varied. The different types of awareness from the model can help us understand the explicit details of how care providers communicate and exchange information with one another. Increased understanding of ICC awareness can assist with the design and evaluation of HISs to support collaborative activities.

[1]  Adam B. Wilcox,et al.  A framework for information system usage in collaborative care , 2007, J. Biomed. Informatics.

[2]  Sameer Malhotra,et al.  Workflow modeling in critical care: Piecing together your own puzzle , 2007, J. Biomed. Informatics.

[3]  Jonathan Grudin,et al.  Computer-supported cooperative work: history and focus , 1994, Computer.

[4]  Nandan Parameswaran,et al.  Awareness modelling in collaborative mobile e-health , 2008, Journal of telemedicine and telecare.

[5]  Mary Beth Rosson,et al.  Beyond being aware , 2009, Inf. Organ..

[6]  A. Strauss,et al.  Basics of qualitative research: Grounded theory procedures and techniques. , 1993 .

[7]  D. Coplen Types of Unintended Consequences Related to Computerized Provider Order Entry , 2007 .

[8]  Howard Abrams,et al.  Electronic inpatient whiteboards: Improving multidisciplinary communication and coordination of care , 2009, Int. J. Medical Informatics.

[9]  Ashley Edwards,et al.  Synchronous communication facilitates interruptive workflow for attending physicians and nurses in clinical settings , 2009, Int. J. Medical Informatics.

[10]  Peter D. Stetson,et al.  Approach to mobile information and communication for health care , 2004, Int. J. Medical Informatics.

[11]  Joan S. Ash,et al.  Qualitative evaluation of health information exchange efforts , 2007, J. Biomed. Informatics.

[12]  Marc Berg,et al.  The mantra of modeling and the forgotten powers of paper: a sociotechnical view on the development of process-oriented ICT in health care , 2003, Int. J. Medical Informatics.

[13]  John Yen,et al.  Challenges to effective crisis management: Using information and communication technologies to coordinate emergency medical services and emergency department teams , 2009, Int. J. Medical Informatics.

[14]  Madhu C. Reddy,et al.  Evaluating collaborative features of critical care systems: A methodological study of information technology in surgical intensive care units , 2008, J. Biomed. Informatics.

[15]  G. G. Stokes "J." , 1890, The New Yale Book of Quotations.

[16]  F. Cabitza,et al.  Leveraging Coordinative Conventions to Promote Collaboration Awareness . The case of Clinical Records , 2008 .

[17]  Jakob E. Bardram,et al.  Context-Based Workplace Awareness , 2010, Computer Supported Cooperative Work (CSCW).

[18]  Marc Berg,et al.  Viewpoint Paper: Some Unintended Consequences of Information Technology in Health Care: The Nature of Patient Care Information System-related Errors , 2003, J. Am. Medical Informatics Assoc..

[19]  Paul Dourish,et al.  Awareness and coordination in shared workspaces , 1992, CSCW '92.

[20]  Chris O'Connor,et al.  Research Paper: The Use of Wireless E-Mail to Improve Healthcare Team Communication , 2009, J. Am. Medical Informatics Assoc..

[21]  Sebastian Garde,et al.  Towards Semantic Interoperability for Electronic Health Records , 2007, Methods of Information in Medicine.

[22]  Carl Gutwin,et al.  A Descriptive Framework of Workspace Awareness for Real-Time Groupware , 2002, Computer Supported Cooperative Work (CSCW).

[23]  Marc Berg,et al.  Building an inter-organizational communication network and challenges for preserving interoperability , 2008, Int. J. Medical Informatics.

[24]  Carla Simone,et al.  Leveraging Coordinative Conventions to Promote Collaboration Awareness , 2009, Computer Supported Cooperative Work (CSCW).

[25]  Madhu C. Reddy,et al.  Collaborative information seeking: A field study of a multidisciplinary patient care team , 2008, Inf. Process. Manag..

[26]  Eric G. Poon,et al.  Research Paper: The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry , 2007, J. Am. Medical Informatics Assoc..

[27]  Diane H. Sonnenwald,et al.  Information behavior in dynamic group work contexts: interwoven situational awareness, dense social networks and contested collaboration in command and control , 2000, Inf. Process. Manag..

[28]  A. Strauss,et al.  Grounded theory methodology: An overview. , 1994 .

[29]  E BardramJakob,et al.  Context-Based Workplace Awareness , 2010 .

[30]  Joan S. Ash,et al.  Report of conference Track 4: socio-technical issues of HIS , 2003, Int. J. Medical Informatics.

[31]  Frederico T. Fonseca,et al.  The double role of ontologies in information science research , 2007, J. Assoc. Inf. Sci. Technol..

[32]  N. Denzin,et al.  Handbook of Qualitative Research , 1994 .

[33]  Jakob E. Bardram,et al.  Context-Based Workplace Awareness - Concepts and Technologies for Supporting Distributed Awareness i , 2010 .