kyhlback ITHC Portland

Information about kyhlback ITHC Portland

Published on January 11, 2008

Author: Diana

Source: authorstream.com

Content

What does it take to replace an old functioning information system with a new one? A case study:  What does it take to replace an old functioning information system with a new one? A case study Hans Kyhlbäck and Berthel Sutter Blekinge Institute of Technology, SWEDEN IT in Health Care, Second International Conference 13-14 September 2004 Portland, Oregon, USA Author presentation:  Author presentation Berthel Sutter School of Mangament Blekinge Institute of Technology Sweden Hans Kyhlbäck School of Engineering Blekinge Institute of Technology Sweden Paper manufacturing shop floor workers (1970´s):  Paper manufacturing shop floor workers (1970´s) Slide4:  Sheet metal, hydraulic press machine operator (1980´s) Slide5:  Sheet metal manufact., maintenance dept. (80´s) The author in the 80´s What does it take to replace an old functioning information system with a new one?:  What does it take to replace an old functioning information system with a new one? Our first claim An old-fashioned information system within health care work will not success-fully be replaced by a new one, - unless the new is better “as a whole”, - that is, better supports work practices of a range of occupational and professional workers. Our second claim:  Our second claim The dilemmas system designers almost always will face when designing information system for the public sector is based on: - a contradiction between central, high level interest and a local level work-practice perspective. Work practice of municipal nurses:  Work practice of municipal nurses Our study reveals that work practice of the municipal nurses is characterized by three distinctive features: - high mobility, - the need for face-to-face interaction in different locations, - a great variety of artefact usage The bag on wheels and the cup board at a residents home :  The bag on wheels and the cup board at a residents home Materials and methods:  Materials and methods The investigation of municipal wound care was accomplished by ethnographic work: - in taking notes, shooting digital photos, collecting material artefacts in use and making audio recorded interviews. Our methodology, Developmental Work Research (DWR), might open up for a needed paradigm shift to involve practitioners in work-oriented design of computer artefacts. Principles of Developmental Work Research (DWR) summarized::  Principles of Developmental Work Research (DWR) summarized: “First, a collective activity system can be taken as the unit of analysis, giving context and meaning to seemingly random individual events. Second, the activity system and its components can be understood historically. Third, inner contradictions of the activity system can be analyzed as the source of disruption, innovation, change, and development of that system, including its individual participants.” Yrjö Engeström. 1993. Wound treatment has significantly changed :  Wound treatment has significantly changed Today, a wound is systematically diagnosed and a more advanced treatment is provided. “There is a need of a unified documentation. Today we have a number of home-made case books” …and the introduction of digital photos on wounds, coincide as the motive for our case, a process of redesign of the old socio-technical wound care system and transforming it into a more advanced and unified tool. Paper form page 1(3) Today in use at Ronneby Elder Care:  Paper form page 1(3) Today in use at Ronneby Elder Care PD session, paper forms from today practice put on the table (photo March 2003):  PD session, paper forms from today practice put on the table (photo March 2003) Slide15:  HELAR Computer prototype, include digital photos Contradiction between the old and a new way in municipal elder care:  Contradiction between the old and a new way in municipal elder care We encounter an upcoming contradiction between the old and a new way to document work that requires an extended set of skills to perform. To make a feasible switch, it seems as it will be needed, at one time, to exchange most of the paper document work with an all-embracing computer system. To be seated like an office white-collar worker:  To be seated like an office white-collar worker A contradiction between a mind set that permeates software development and essential qualities of nurses work practice is revealed. Some of the observed difficulties are about recognition and making connections between different devices on a “simple” level of artefact-artefact interaction. To do those things right, the nurse has to be seated like an office white-collar worker. One size do not fit all:  One size do not fit all If sitting by the desk top computer all day long is the reality for computer system developers, one small size on the scale of widgets, buttons etc. is appropriate, - if being on the go and on the move – as the nurses are - a second larger size is required. Essential characteristics of the nurse occupational work (1) :  Essential characteristics of the nurse occupational work (1) Essential characteristics of the nurse occupational work (2) :  Essential characteristics of the nurse occupational work (2) What it takes to replace an old IS with a new one in municipal care:  What it takes to replace an old IS with a new one in municipal care Possible computer solutions supporting more complex and advanced activity systems, as for example municipal wound care, require: - to take the practitioners seriously, - to deal with power relations and - to develop more fine tuned measures on needed scale and size properties of interface constructions. Implications of the DWR approach:  Implications of the DWR approach - Our method points in the direction of exploring observed tensions and contradictions as resources for design of new solutions – let it be either redesign of practice or creation of new technology. - The DWR approach implies research in the field, in close contact with practitioners at work. This is true for the gathering of key artefacts in use, but also when it comes to development of computer system. - The methodology invites us to do participatory design and participatory evaluation of the new artefact. What does it take to replace an old functioning information system with a new one? A case study:  What does it take to replace an old functioning information system with a new one? A case study End of presentation Address for correspondence Hans Kyhlbäck Blekinge Institute of Technology SE- 372 25 Ronneby, Sweden E-mail: [email protected]

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