Envisioning healthcare work: models for prospective evaluation of new systems

When healthcare organizations plan the introduction of advanced health information systems, they need to envision future use. In this paper we describe four different ways of modeling the flow of information in a healthcare context: normative, indicating how information should flow; descriptive, indicating how information does flow now; formative, indicating how information could flow; and projective, indicating how information will flow with a specific new health information system. All approaches must work together for analysts to envision future use effectively. We illustrate the above distinctions with a case study based in the Department of Diagnostic Radiology (DDR) in a major tertiary hospital. DDR personnel were considering the introduction of software to help them schedule patient porterage (transport) services to, from, and within the department. Our prospective evaluation method let personnel see advantages and disadvantages of different ways of deploying the porterage software and led to the specification and design of the ValuesViewer™ application.