Unveiling High-speed Follow-up Consultation for Chronic Disease Treatment: A Pediatric Hospital Case in China

Abstract

In developing countries suffering from a severe shortage of physicians, the follow-up clinical consultation of long-term chronic care becomes a high-speed collaborative work, which has to be conducted in a few minutes. Although much existing work studies how time factors affect physicians' workflows and requirements for information systems, high-speed chronic care is yet to be well investigated. This work bridges the gap by presenting a case of a pediatric hospital in China. We focus on the processes of follow-up consultations, the factors enabling physicians to complete consultation in several minutes, as well as the challenges faced by physicians and patients. Through observations and interviews, we find that physicians conduct multiple tasks (information acquisition, patient-provider communication, and medical data documentation) simultaneously to reduce the consultation duration. Adopting an information summary alternative is the key to fast information acquisition. Templates and references in EMR contribute to rapid documentation and prescription. However, multitasking brings physicians a heavy cognitive load. It also severely compresses the duration of patient-provider communication. As a result, some of the patients' needs, especially emotional ones, are neglected. Based on these findings, we discuss the characteristics and requirements of high-speed chronic care and accordingly propose design suggestions.