PubMed · 11409276
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S M Barcia. 2001. Managing change.. https://pubmed.ncbi.nlm.nih.gov/11409276/
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Physician order entry is a powerful function of a computerized hospital information system. Although designed to be clinician-driven, the imaging section of the order entry system may not be designed optimally to engage the clinician with imaging procedures logically organized for the clinician's typical work patterns. There also may be resistance among overburdened clinicians in having to take the time to learn a new computer system and to assume "clerk's duties" of entering imaging orders. A potential means to address clinician opposition is to cooperatively engage each clinical service in the design of an imaging order entry system with customized menus for each service. This article reports a step-by-step process for the implementation of an imaging order entry system with specialized menus for an orthopedic service. This implementation process includes (1) identification of key personnel, (2) familiarization with the system, (3) discussion and dialogue between key personnel, (4) addressing specific problems, (5) education and orientation of the target group, (6) initial implementation, (7) feedback and improvement, (8) demonstration project (time study) to foster acceptance, and (9) ongoing enhancement.
A two-stage process is proposed for evaluating computer aiding in cognitive work domains. The first stage relies on a taxonomic framework that facilitates assessments regarding the relative strengths and weaknesses of humans and computers for different computer-aiding schemes. The second stage introduces the construct of tension, which addresses the potential implications of the interplay between computer aiding constraints and human tendencies. This approach is intended to provide designers, analysts and managers with greater insight into the nature of computer aiding and ultimately to enhance their ability to predict its effectiveness as well as its prospects for being used.