Evaluating Healthcare IT and Understanding the Work of Healthcare are Entangled Processes

Abstract

Parallel to the monumental problem of replacing paper- and pen-based patient information management systems with electronic ones is the problem of evaluating the extent to which the change represents an improvement. Meaningful and useful evaluation rests upon: a) explicitly conceptualizing the goals and tasks of the daily clinical work; b) thinking of electronic information management technology as a cognitive tool; c) explicitly representing in the tool the pertinent information elements; d) selecting among possibilities for representing a problem formulation so as to facilitate the solution; and e) appreciating the dynamic interaction between the work and the tool–that changing a tool necessarily changes the work. Anchored in the story of how one hospital committee learned to think about the purpose and impact of a patient information management system, this chapter gives practical insight to these evaluative considerations.