Abstract
BackgroundExperience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings.MethodsA multiple case study including nine case studies conducted by DaCHI researchers 2004–2011 using audio-visual, non-participant video observation for data collection within different healthcare settings.ResultsIn HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices.ConclusionsThe video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.
Highlights
Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice
The individual results are not presented, as the objective of this paper is to argue for the relevance of the video observation technique to provide insight into sociomateriality and by doing so inform and improve health information technology development
By employing and further developing the video observation technique, we have found, that it is superior to other ethnographic research techniques when it comes to disclosing the complexity in clinical sociomaterial work practice
Summary
Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context including parts of the tacit practice. A precondition for the development of successful health information technologies, that provide clinical benefits, is that HIT development and implementation is based on a thorough insight into clinical work practice.
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