Use of Clinical Simulations to Evaluate the Impact of Health Information Systems and Ubiquitous Computing Devices Upon Health Professional Work

Introduction

Health information systems (HIS) and in particular ubiquitous computing devices (UCD) have promised to revolutionize healthcare. Early research in this area demonstrated the value of integrating varying HIS and UCD into clinical settings in terms of improving the quality of patient care and reducing medical error rates (e.g. Bates et al., 1999; Chaudry et al., 2006). More recent research has called into question some of these findings. Some researchers have identified that poor cognitive, social and technical fit may influence some implementations of HIS and UCD and be the cause of health professional adoption and appropriation failures (Borycki et al., 2009a). In healthcare the hospital and clinic costs associated with implementing and re-implementing a HIS and UCD can be significant. There is a need to develop new evaluation methodologies that allow for testing of differing constellations or groupings of HIS and UCD prior to their implementation in clinical settings to reduce the likelihood of costs being associated with health professional adoption and appropriation failure. The authors of this book chapter will introduce a novel methodology that can be used to evaluate the cognitive-socio-technical fit of HISs and UCD prior to their implementation in real world clinical settings. This may prevent poor adoption and appropriation of these technologies. The authors will begin this chapter by first introducing the reader to the literature involving HIS and UCD successes and failures. This will be followed by a brief introduction to the theory of cognitive–socio-technical fit as applied to HIS and UCD in clinical settings. Following this, the authors of the book chapter will describe the new and emerging area of HIS evaluation involving the use of clinical simulations. This section of the book chapter will not only describe the background and rationale for using clinical simulations to evaluate HIS and UCD, but will also describe the steps in the evaluation method and provide examples from the authors’ work. The authors will use examples from their previous research to illustrate the use of clinical simulations as an evaluation methodology for HIS and UCD.