Viewpoint: When Conversation Is Better Than Computation

While largely ignored in informatics thinking, the clinical communication space accounts for the major part of the information flow in health care. Growing evidence indicates that errors in communication give rise to substantial clinical morbidity and mortality. This paper explores the implications of acknowledging the primacy of the communication space in informatics and explores some solutions to communication difficulties. It also examines whether understanding the dynamics of communication between human beings can also improve the way we design information systems in health care. Using the concept of common ground in conversation, proposals are suggested for modeling the common ground between a system and human users. Such models provide insights into when communication or computational systems are better suited to solving information problems.

[1]  Herbert H. Clark,et al.  Grounding in communication , 1991, Perspectives on socially shared cognition.

[2]  Stephanie D. Teasley,et al.  Perspectives on socially shared cognition , 1991 .

[3]  Frank Sullivan,et al.  Has general practitioner computing made a difference to patient care? A systematic review of published reports , 1995, BMJ.

[4]  E. Rogers Diffusion of Innovations , 1962 .

[5]  Morroe Berger,et al.  Freedom and control in modern society , 1954 .

[6]  M. Markus Electronic Mail as the Medium of Managerial Choice , 1994 .

[7]  D. Covell,et al.  Information needs in office practice: are they being met? , 1985, Annals of internal medicine.

[8]  Nancy M. Lorenzi,et al.  Review: Antecedents of the People and Organizational Aspects of Medical Informatics: Review of the Literature , 1997, J. Am. Medical Informatics Assoc..

[9]  D M Rind,et al.  Online medical records: a decade of experience. , 1999, Methods of information in medicine.

[10]  Marc Berg,et al.  Rationalizing Medical Work: Decision-support Techniques and Medical Practices , 2022 .

[11]  E. Coiera Clinical communication: a new informatics paradigm. , 1996, Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium.

[12]  Jennifer Preece,et al.  Informal Communication is about Sharing Objects in Media , 1996, Interact. Comput..

[13]  E Coiera The impact of culture on technology , 1999, The Medical journal of Australia.

[14]  R. Gibberd,et al.  The Quality in Australian Health Care Study , 1995, The Medical journal of Australia.

[15]  J R Scherrer,et al.  An integrated hospital information system in Geneva. , 1990, M.D. computing : computers in medical practice.

[16]  P. Tang,et al.  Clinician information activities in diverse ambulatory care practices. , 1996, Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium.

[17]  H. Britt,et al.  Analysing potential harm in Australian general practice: an incident‐monitoring study , 1998, The Medical journal of Australia.

[18]  Enrico W. Coiera,et al.  Communication behaviours in a hospital setting: an observational study , 1998, BMJ.

[19]  Enrico Coiera,et al.  Guide to medical informatics, the internet and telemedicine Enrico Coiera Guide to Medical Informatics, The Internet and Telemedicine Chapman & Hall 376pp £29.99 0-412-75710-9 0412757109 [Formula: see text]. , 1998, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[20]  Michael M. Wagner,et al.  Design of a clinical notification system , 1999, AMIA.

[21]  P. Lazarsfeld,et al.  Friendship as Social process: a substantive and methodological analysis , 1964 .

[22]  J. Reitman Without surreptitious rehearsal, information in short-term memory decay , 1974 .